Healthcare Provider Details

I. General information

NPI: 1003789546
Provider Name (Legal Business Name): VALERIE GORDON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 PACIFIC AVE
ALAMEDA CA
94501-2125
US

IV. Provider business mailing address

500 PACIFIC AVE
ALAMEDA CA
94501-2125
US

V. Phone/Fax

Practice location:
  • Phone: 510-748-4024
  • Fax:
Mailing address:
  • Phone: 510-748-4024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number20987
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number250205668
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: