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NPI Code Detail

MEDICARE: MS. VALDA JEAN DOUNVEOR MFTI

MEDICARE: MS. VALDA JEAN DOUNVEOR MFTI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1508203860
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VALDA JEAN DOUNVEOR MFTI
Provider Business Mailing Address
First Line : 1000 SAN LEANDRO BLVD
Second Line : STE 300
City : SAN LEANDRO
State : CA
Zip : 94577-1598
Country : US
Telephone Number : 510-725-2967
Fax Number :
Provider Business Practice Location Address
First Line : 1926 E 19TH ST
Second Line :
City : OAKLAND
State : CA
Zip : 94606-4126
Country : US
Telephone Number : 510-879-2120
Fax Number : 510-351-1367
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2013
Last Update Date : 05/28/2013

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