Healthcare Provider Details

I. General information

NPI: 1265753560
Provider Name (Legal Business Name): VICTOR DAVID VALDEZ B.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 E DYER RD STE 200
SANTA ANA CA
92705-5700
US

IV. Provider business mailing address

1821 E DYER RD STE 200
SANTA ANA CA
92705-5700
US

V. Phone/Fax

Practice location:
  • Phone: 949-250-0488
  • Fax: 949-251-1659
Mailing address:
  • Phone: 949-250-0488
  • Fax: 949-251-1659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: