Provider Demographics
NPI:1336755982
Name:VALDEZ, JOCELINE LIZETH
Entity type:Individual
Prefix:
First Name:JOCELINE
Middle Name:LIZETH
Last Name:VALDEZ
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 1:723 W 92ND ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90044-4730
Mailing Address - Country:US
Mailing Address - Phone:323-893-1209
Mailing Address - Fax:
Practice Address - Street 1:5301 ELMER WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-2414
Practice Address - Country:US
Practice Address - Phone:916-395-5360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor