Provider Demographics
NPI:1194069799
Name:VALERO, MARISSA JACLYN (LMFT)
Entity type:Individual
Prefix:MS
First Name:MARISSA
Middle Name:JACLYN
Last Name:VALERO
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-2014
Mailing Address - Country:US
Mailing Address - Phone:559-380-8881
Mailing Address - Fax:
Practice Address - Street 1:3600 W ORCHARD CT
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-7083
Practice Address - Country:US
Practice Address - Phone:559-290-1669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76656101YM0800X
CAMFC106108106H00000X
CAIMF76656106H00000X
CALMFT106108106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health