Healthcare Provider Details

I. General information

NPI: 1063936409
Provider Name (Legal Business Name): GABRIELA VALENCIA MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5740 RALSTON ST STE 100
VENTURA CA
93003-7847
US

IV. Provider business mailing address

5740 RALSTON ST STE 100
VENTURA CA
93003-7847
US

V. Phone/Fax

Practice location:
  • Phone: 805-289-3310
  • Fax: 805-289-3395
Mailing address:
  • Phone: 805-289-3310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW118295
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: