Provider Demographics
NPI:1992109771
Name:VALDEZ, DARLENE ANN (MA)
Entity type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:ANN
Last Name:VALDEZ
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 1:1845 N BROADWAY
Mailing Address - Street 2:APT 217
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-2089
Mailing Address - Country:US
Mailing Address - Phone:858-335-8629
Mailing Address - Fax:
Practice Address - Street 1:3020 CHILDRENS WAY # 5002
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4223
Practice Address - Country:US
Practice Address - Phone:858-966-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-22
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPE 9362235Z00000X
CA23085235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist