Healthcare Provider Details

I. General information

NPI: 1982161030
Provider Name (Legal Business Name): LAUREN T VALVERDE MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6770 N WEST AVE STE 105
FRESNO CA
93711-1399
US

IV. Provider business mailing address

PO BOX 767938
ROSWELL GA
30076-7938
US

V. Phone/Fax

Practice location:
  • Phone: 818-241-6780
  • Fax: 818-241-6853
Mailing address:
  • Phone: 818-241-6780
  • Fax: 818-241-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-44245
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-17-33268
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: