Healthcare Provider Details

I. General information

NPI: 1669340725
Provider Name (Legal Business Name): JEFFREY NICHOLAS VALKO AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N BROOKHURST ST
ANAHEIM CA
92801-5227
US

IV. Provider business mailing address

2777 ALTON PKWY APT 133
IRVINE CA
92606-3145
US

V. Phone/Fax

Practice location:
  • Phone: 714-333-3559
  • Fax:
Mailing address:
  • Phone: 949-449-9755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number159111
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: