MEDICARE: DR. BEVERLY VALENTINE PSY.D.

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
1	103TC0700X	Clinical Psychologist	4244	AZ

General Provider Information

NPI Number	:	1730480856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BEVERLY VALENTINE PSY.D.

Provider Business Mailing Address
First Line	:	1734 E SILVER CREEK RD
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85296-2041
Country	:	US
Telephone Number	:	480-341-1885
Fax Number	:

Provider Business Practice Location Address
First Line	:	3303 E BASELINE RD STE 109
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85234-2739
Country	:	US
Telephone Number	:	480-341-1885
Fax Number	:	602-753-9527

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2010
Last Update Date	:	03/15/2023

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