Healthcare Provider Details

I. General information

NPI: 1336764885
Provider Name (Legal Business Name): VALERIA C VENTURA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 39TH ST
RICHMOND CA
94805-2212
US

IV. Provider business mailing address

4125 SALEM ST
CONCORD CA
94521-1801
US

V. Phone/Fax

Practice location:
  • Phone: 510-412-5930
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number128036
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: