Healthcare Provider Details

I. General information

NPI: 1598625196
Provider Name (Legal Business Name): VIRIDIANA VALIENTE AMFT, APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2025
Last Update Date: 11/15/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 N D ST
SAN BERNARDINO CA
92405-4747
US

IV. Provider business mailing address

2234 W 3RD AVE
SAN BERNARDINO CA
92407-6007
US

V. Phone/Fax

Practice location:
  • Phone: 909-491-3307
  • Fax:
Mailing address:
  • Phone: 909-645-9049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number17923
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number151155
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: