Provider Demographics
NPI:1386453678
Name:VALENTE, MAECYLL SAMINISTRADO
Entity type:Individual
Prefix:
First Name:MAECYLL
Middle Name:SAMINISTRADO
Last Name:VALENTE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5558 CALIFORNIA AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0710
Mailing Address - Country:US
Mailing Address - Phone:661-326-1577
Mailing Address - Fax:
Practice Address - Street 1:1075 CREEKSIDE RIDGE DR STE 280
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-3504
Practice Address - Country:US
Practice Address - Phone:661-487-4559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-02
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician