Provider Demographics
NPI:1144718719
Name:CARRERA VASQUEZ, VALERIA FERNANDA (MS: PSYCHOLOGY)
Entity type:Individual
Prefix:
First Name:VALERIA
Middle Name:FERNANDA
Last Name:CARRERA VASQUEZ
Suffix:
Gender:F
Credentials:MS: PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 SCARONI AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231-9702
Mailing Address - Country:US
Mailing Address - Phone:760-562-2739
Mailing Address - Fax:
Practice Address - Street 1:300 S IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-3149
Practice Address - Country:US
Practice Address - Phone:760-679-0540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-28
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-24-77546103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician