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General NPI Number Information
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NPI Number | 1699333138
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Entity Type | Individual
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Provider Name | SEAN VINCENT VALLOR LMFT, APC
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Gender | Male
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 310 HARBOR BLVD BLDG E
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City | BELMONT
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State | CA
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Zip | 94002-4018
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Country | US
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Telephone | 650-480-0865
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Fax | 650-591-3043
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Provider Business Mailing Address
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Address Line | 310 HARBOR BLVD BLDG E
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City | BELMONT
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State | CA
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Zip | 94002-4018
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Country | US
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Telephone | 650-480-0865
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APCC4872
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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 | AMFT105081
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License Number State | CA
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