Provider Demographics
NPI:1306087002
Name:VALERO, STELLA ANN
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:ANN
Last Name:VALERO
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 1:1617 E SAGINAW WAY
Mailing Address - Street 2:SUITE #102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-4458
Mailing Address - Country:US
Mailing Address - Phone:559-274-0299
Mailing Address - Fax:559-244-0348
Practice Address - Street 1:1617 E SAGINAW WAY
Practice Address - Street 2:SUITE #102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-4458
Practice Address - Country:US
Practice Address - Phone:559-274-0299
Practice Address - Fax:559-244-0328
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health