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General NPI Number Information
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NPI Number | 1053285387
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Entity Type | Individual
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Provider Name | VALERIE S NIETO RADT I
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Gender | Female
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Dates
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Enumeration Date | 09/30/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 7150 BROADWAY
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City | LEMON GROVE
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State | CA
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Zip | 91945-1401
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Country | US
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Telephone | 619-255-5167
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Fax |
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Provider Business Mailing Address
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Address Line | 1425 SECOND AVE SPC 113
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City | CHULA VISTA
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State | CA
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Zip | 91911-5017
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Country | US
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Telephone | 619-255-5167
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | R1620540725
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License Number State | CA
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