Provider Demographics
NPI:1831760081
Name:VALENCIA, VANESSA MARIE
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:MARIE
Last Name:VALENCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5329 OFFICE CENTER CT STE 150
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-7403
Mailing Address - Country:US
Mailing Address - Phone:661-376-9464
Mailing Address - Fax:
Practice Address - Street 1:1500 PACHECO RD SPC 25
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-0903
Practice Address - Country:US
Practice Address - Phone:661-376-9464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician