Healthcare Provider Details

I. General information

NPI: 1780217182
Provider Name (Legal Business Name): VALERIE M HAMILTON RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VALERIE M RUSSELL

II. Dates (important events)

Enumeration Date: 02/14/2020
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41769 ENTERPRISE CIR N
TEMECULA CA
92590-5626
US

IV. Provider business mailing address

2130 S SANTA FE AVE APT 48
VISTA CA
92084-7854
US

V. Phone/Fax

Practice location:
  • Phone: 951-800-8701
  • Fax:
Mailing address:
  • Phone: 281-678-1651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: