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General NPI Number Information
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NPI Number | 1245744622
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Entity Type | Individual
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Provider Name | MICHELLE VALENZUELA MS
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Gender | Female
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 1575 ALLOUEZ AVE
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City | GREEN BAY
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State | WI
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Zip | 54311-5625
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Country | US
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Telephone | 920-857-9041
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Fax | 920-857-3366
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Provider Business Mailing Address
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Address Line | 17101 SPRINGDALE ST APT 238
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92649-4683
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Country | US
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Telephone | 714-624-3435
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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Taxonomy #4
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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Taxonomy #5
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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Taxonomy #6
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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