Healthcare Provider Details

I. General information

NPI: 1700520871
Provider Name (Legal Business Name): SYDNEY VALDEZ MA,LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2677 N MAIN ST STE 130
SANTA ANA CA
92705-6665
US

IV. Provider business mailing address

PO BOX 890131
TEMECULA CA
92589-0131
US

V. Phone/Fax

Practice location:
  • Phone: 800-801-9833
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number151703
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: