Healthcare Provider Details

I. General information

NPI: 1396607297
Provider Name (Legal Business Name): VALERIE JEAN CIPOLLONE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2025
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 SCENIC AVE
BERKELEY CA
94709-1324
US

IV. Provider business mailing address

2323 HEARST AVE
BERKELEY CA
94709-1319
US

V. Phone/Fax

Practice location:
  • Phone: 866-772-8491
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number26794
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: