Provider Demographics
NPI:1972887826
Name:GREENHECK-SUENNEN, VALLEE JEAN (MA)
Entity type:Individual
Prefix:MS
First Name:VALLEE
Middle Name:JEAN
Last Name:GREENHECK-SUENNEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1470 CIVIC COURT
Mailing Address - Street 2:111
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-7979
Mailing Address - Country:US
Mailing Address - Phone:925-219-9009
Mailing Address - Fax:925-689-7436
Practice Address - Street 1:1410 DANZIG PLZ
Practice Address - Street 2:102
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-7979
Practice Address - Country:US
Practice Address - Phone:925-399-8743
Practice Address - Fax:925-399-8750
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CAIMF73736390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No171M00000XOther Service ProvidersCase Manager/Care Coordinator