Doctor Name: | MS. JENNIFER VALLEJO |
NPI Number: | 1114234291 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 24330 Narbonne Ave Lomita, CA - 907171131 |
Business Phone Number: | 3105341083 |
Business Fax Number: | |
Mailing Address: | 11715 Patton Rd, DOWNEY |
State: | CA |
Postal Code: | 902415234 |
Phone Number: | 5626448662 |
Fax Number: | |
NPI Enumeration Date: | 09/09/2010 |
NPI Last Update Date: | 11/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |