Healthcare Provider Details

I. General information

NPI: 1639034135
Provider Name (Legal Business Name): VALERIE GRIJALVA PRICHARD
Entity Type: Individual
Gender:
Sole Proprietor: Y

Provider Other Name: VALERIE ANNE GRIJALVA LMFT

II. Dates (important events)

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

III. Provider practice location address

17195 NEWHOPE ST STE 205
FOUNTAIN VALLEY CA
92708-4211
US

IV. Provider business mailing address

17195 NEWHOPE ST STE 205
FOUNTAIN VALLEY CA
92708-4211
US

V. Phone/Fax

Practice location:
  • Phone: 657-360-4329
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number155105
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: