Healthcare Provider Details

I. General information

NPI: 1578438024
Provider Name (Legal Business Name): MICHAEL STEVE VALDIVIESO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 ELDRIDGE AVE
SYLMAR CA
91342-6506
US

IV. Provider business mailing address

11600 ELDRIDGE AVE
SYLMAR CA
91342-6506
US

V. Phone/Fax

Practice location:
  • Phone: 818-686-3000
  • Fax:
Mailing address:
  • Phone: 818-686-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: