Healthcare Provider Details

I. General information

NPI: 1871654095
Provider Name (Legal Business Name): STEVEN MATTHEW VALDESPINO MA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ALHAMBRA AVE-3C
MARTINEZ CA
94553
US

IV. Provider business mailing address

1340 ARNOLD DR STE 200
MARTINEZ CA
94553-4189
US

V. Phone/Fax

Practice location:
  • Phone: 925-646-2800
  • Fax:
Mailing address:
  • Phone: 925-646-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: