Healthcare Provider Details

I. General information

NPI: 1518485531
Provider Name (Legal Business Name): DIANA ROSAMARIA CHAVEZ VALENCIA MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10650 REAGAN ST UNIT 73
LOS ALAMITOS CA
90720-8804
US

IV. Provider business mailing address

10650 REAGAN ST UNIT 73
LOS ALAMITOS CA
90720-8804
US

V. Phone/Fax

Practice location:
  • Phone: 323-510-7365
  • Fax:
Mailing address:
  • Phone: 323-510-7365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number138090
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: