Healthcare Provider Details

I. General information

NPI: 1336938166
Provider Name (Legal Business Name): MARTHA ALICIA VALENCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6736 LAUREL CANYON BLVD STE 200
NORTH HOLLYWOOD CA
91606-1576
US

IV. Provider business mailing address

6813 LINDLEY AVE
RESEDA CA
91335-4609
US

V. Phone/Fax

Practice location:
  • Phone: 818-755-8786
  • Fax:
Mailing address:
  • Phone: 818-462-1830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: