Healthcare Provider Details

I. General information

NPI: 1417538885
Provider Name (Legal Business Name): JOCELYN VALDES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2021
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6760 N WEST AVE
FRESNO CA
93711-1396
US

IV. Provider business mailing address

950 BROADWAY STE 301
TACOMA WA
98402-4454
US

V. Phone/Fax

Practice location:
  • Phone: 866-523-4268
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberAB70142092
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: