Provider Demographics
NPI:1073842662
Name:VALDEZ HERNANDEZ, ISRAEL (LCSW)
Entity type:Individual
Prefix:MR
First Name:ISRAEL
Middle Name:
Last Name:VALDEZ HERNANDEZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 14TH ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-3815
Mailing Address - Country:US
Mailing Address - Phone:951-955-1540
Mailing Address - Fax:
Practice Address - Street 1:1791 W ACACIA AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-3797
Practice Address - Country:US
Practice Address - Phone:951-765-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1002251041C0700X
CA77223101YM0800X
101YM0800X, 390200000X
CA225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program