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General NPI Number Information
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NPI Number | 1063810430
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Entity Type | Individual
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Provider Name | JAMIE VALLE
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Gender | Female
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Dates
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Enumeration Date | 12/16/2014
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 4211 AVALON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90011-5622
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Country | US
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Telephone | 323-233-0425
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Fax | 323-232-2366
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Provider Business Mailing Address
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Address Line | 1000 S HILL RD STE 100
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City | VENTURA
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State | CA
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Zip | 93003-4455
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Country | US
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Telephone | 805-477-7742
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Fax | 805-477-7740
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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 | 82549
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License Number State | CA
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