Provider Demographics
NPI:1316074180
Name:VALONE, KEITH EMERSON (PHD, PSYD)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:EMERSON
Last Name:VALONE
Suffix:
Gender:M
Credentials:PHD, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 W CALIFORNIA BLVD
Mailing Address - Street 2:SUITE 321
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3029
Mailing Address - Country:US
Mailing Address - Phone:626-405-9066
Mailing Address - Fax:
Practice Address - Street 1:1 W CALIFORNIA BLVD
Practice Address - Street 2:SUITE 321
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3029
Practice Address - Country:US
Practice Address - Phone:626-405-9066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7843103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical