Provider Demographics
NPI:1265753560
Name:VALDEZ, VICTOR DAVID (BA)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:DAVID
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 E DYER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5700
Mailing Address - Country:US
Mailing Address - Phone:949-250-0488
Mailing Address - Fax:949-251-1659
Practice Address - Street 1:1821 E DYER RD STE 200
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5700
Practice Address - Country:US
Practice Address - Phone:949-250-0488
Practice Address - Fax:949-251-1659
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health