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General NPI Number Information
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NPI Number | 1811422488
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Entity Type | Organization
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Legal Business Name | MARLENE W. VALTER, PSYD
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Dates
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Enumeration Date | 04/20/2017
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 2625 TOWNSGATE RD SUITE 330
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-5751
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Country | US
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Telephone | 805-813-3774
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Fax | 805-531-0021
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Provider Business Mailing Address
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Address Line | 2625 TOWNSGATE RD SUITE 330
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-5751
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Country | US
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Telephone | 805-813-3774
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Fax | 805-531-0021
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARLENE W VALTER
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Credential | PSYD
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Telephone | 805-813-3774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | PSY17095
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License Number State | CA
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