Provider Demographics
NPI:1306241674
Name:VALLE, JOSE JESUS (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:JESUS
Last Name:VALLE
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11322 QUAIL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1714
Mailing Address - Country:US
Mailing Address - Phone:818-585-9230
Mailing Address - Fax:
Practice Address - Street 1:19300 RINALDI ST UNIT 7914
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91327-8846
Practice Address - Country:US
Practice Address - Phone:747-767-9777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-29
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA907681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health