Provider Demographics
NPI:1720648033
Name:VALENTON, YESICA YERALDIN
Entity type:Individual
Prefix:
First Name:YESICA
Middle Name:YERALDIN
Last Name:VALENTON
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 1:15010 FIR ST
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-4316
Mailing Address - Country:US
Mailing Address - Phone:760-669-5297
Mailing Address - Fax:760-669-5905
Practice Address - Street 1:15010 FIR ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-4316
Practice Address - Country:US
Practice Address - Phone:760-669-5297
Practice Address - Fax:760-669-5905
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA151629106H00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program