Provider Demographics
NPI:1154601359
Name:VALADEZ, BRENDA ABIGAIL
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:ABIGAIL
Last Name:VALADEZ
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 1:234 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-4558
Mailing Address - Country:US
Mailing Address - Phone:626-945-8818
Mailing Address - Fax:
Practice Address - Street 1:234 N 3RD ST
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-4558
Practice Address - Country:US
Practice Address - Phone:626-945-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist