Provider Demographics
NPI:1669340725
Name:VALKO, JEFFREY NICHOLAS (AMFT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:NICHOLAS
Last Name:VALKO
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2777 ALTON PKWY APT 133
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-3145
Mailing Address - Country:US
Mailing Address - Phone:949-449-9755
Mailing Address - Fax:
Practice Address - Street 1:520 N BROOKHURST ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-5227
Practice Address - Country:US
Practice Address - Phone:714-333-3559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-29
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA159111106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist