Provider Demographics
NPI:1104536051
Name:DEL VALLE, ASHLEY S (MSW, ACSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:S
Last Name:DEL VALLE
Suffix:
Gender:F
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3886 GOSSAMER WAY
Mailing Address - Street 2:
Mailing Address - City:CERES
Mailing Address - State:CA
Mailing Address - Zip Code:95307-7181
Mailing Address - Country:US
Mailing Address - Phone:209-613-3822
Mailing Address - Fax:
Practice Address - Street 1:600 B ST BLDG B
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:CA
Practice Address - Zip Code:95334-9593
Practice Address - Country:US
Practice Address - Phone:833-850-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1123261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical