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General NPI Number Information
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NPI Number | 1104382902
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Entity Type | Individual
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Provider Name | CHRISTINE ELIZABETH VALDEZ PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/16/2019
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Last Update Date | 02/16/2019
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Provider Practice Location Address
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Address Line | 240 TAMAL VISTA BLVD STE 160
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City | CORTE MADERA
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State | CA
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Zip | 94925-1156
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Country | US
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Telephone | 415-604-2624
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Fax |
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Provider Business Mailing Address
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Address Line | 21100 GARY DR APT 120
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City | HAYWARD
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State | CA
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Zip | 94546-6110
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Country | US
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Telephone | 510-909-7891
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY28590
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License Number State | CA
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