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General NPI Number Information
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NPI Number | 1639503352
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Entity Type | Individual
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Provider Name | NICOLE VALADAO LMFT, RN
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Gender | Female
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Dates
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Enumeration Date | 08/29/2013
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Last Update Date | 03/09/2020
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Provider Practice Location Address
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Address Line | 2625 F COFFEE RD # 132
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City | MODESTO
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State | CA
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Zip | 95355-2053
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Country | US
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Telephone | 209-324-8440
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Fax |
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Provider Business Mailing Address
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Address Line | 2625 F COFFEE RD # 132
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City | MODESTO
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State | CA
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Zip | 95355-2053
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Country | US
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Telephone | 209-324-8440
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 63917
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 102273
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 1022403
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License Number State | CA
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