Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 32439 | CA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 32439 | CA |
NPI | 1114166402 |
---|---|
Provider Name | John A Valenzuela |
First Address | Ojai, CA 93023-2208 |
Second Address | Ojai, CA 93023-2208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2009 |
Last Update Date | 09/07/2021 |