Healthcare Provider Details

I. General information

NPI: 1295373520
Provider Name (Legal Business Name): LUIS ONOFRE VALENCIA MA, APCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2019
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 MARTIN RD STE 200
FAIRFIELD CA
94534-8610
US

IV. Provider business mailing address

8300 ESTERS BLVD STE 900
IRVING TX
75063-2233
US

V. Phone/Fax

Practice location:
  • Phone: 707-428-4198
  • Fax:
Mailing address:
  • Phone: 415-424-4266
  • Fax: 415-520-6633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: