Healthcare Provider Details

I. General information

NPI: 1811023112
Provider Name (Legal Business Name): DAWN ARLINE VALDEZ LPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 ALABAMA ST
VALLEJO CA
94590-4511
US

IV. Provider business mailing address

53 MONTE VISTA AVE
VALLEJO CA
94590-3926
US

V. Phone/Fax

Practice location:
  • Phone: 707-558-1600
  • Fax: 707-558-1606
Mailing address:
  • Phone: 707-552-0661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code167G00000X
TaxonomyLicensed Psychiatric Technician
License NumberPT23149
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: