Healthcare Provider Details

I. General information

NPI: 1689289399
Provider Name (Legal Business Name): CLAUDIA RUBI DEL VALLE ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2020
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S MCDONNELL AVE
COMMERCE CA
90040-5623
US

IV. Provider business mailing address

PO BOX 744
SAN PEDRO CA
90733-0744
US

V. Phone/Fax

Practice location:
  • Phone: 323-267-2392
  • Fax:
Mailing address:
  • Phone: 323-267-2392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number103768
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: