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General NPI Number Information
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NPI Number | 1043048606
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Entity Type | Individual
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Provider Name | SERGIO VALENCIA MSW, PPSC-SSW, ACSW
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Gender | Male
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Dates
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Enumeration Date | 07/24/2024
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 3960 WALNUT DR
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City | EUREKA
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State | CA
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Zip | 95503-8938
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Country | US
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Telephone | 707-268-8722
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Fax |
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Provider Business Mailing Address
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Address Line | 640 12TH ST APT 2
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City | ARCATA
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State | CA
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Zip | 95521-5864
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Country | US
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Telephone | 559-300-2226
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 132065
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License Number State | CA
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