Healthcare Provider Details

I. General information

NPI: 1922925965
Provider Name (Legal Business Name): HOLLY VALERIO, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12625 HIGH BLUFF DR STE 101
SAN DIEGO CA
92130-2053
US

IV. Provider business mailing address

12625 HIGH BLUFF DR STE 101
SAN DIEGO CA
92130-2053
US

V. Phone/Fax

Practice location:
  • Phone: 858-215-4348
  • Fax: 816-339-3952
Mailing address:
  • Phone: 215-948-2577
  • Fax: 816-339-3952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: HOLLY VALERIO
Title or Position: PRESIDENT
Credential: MD
Phone: 215-948-2577