Provider Demographics
NPI:1912123993
Name:ROBINSON, VALENDA DAWN (MFT)
Entity Type:Individual
Prefix:MS
First Name:VALENDA
Middle Name:DAWN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1052
Mailing Address - Street 2:
Mailing Address - City:ANGELS CAMP
Mailing Address - State:CA
Mailing Address - Zip Code:95222
Mailing Address - Country:US
Mailing Address - Phone:510-888-3577
Mailing Address - Fax:954-724-6258
Practice Address - Street 1:39833 PASEO PADRE PKWY.
Practice Address - Street 2:SUITE D
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-2937
Practice Address - Country:US
Practice Address - Phone:510-888-3577
Practice Address - Fax:510-894-2836
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 35975106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist