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Individual

MR. DAVID GREGORY VALLEY

Active
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Individual

MR. DAVID GREGORY VALLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSAC, CLA

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1135-031613A
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
1135-031613A
CA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CORPHQ-1135-031613A
CA
320800000X
Mental Illness Community Based Residential Treatment Facility

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1135-031613A
AOD LICENSE
CA
01
45-4980495
IRS TAX ID
01
DMR0616
NATIONWIDE INSURANC
Enumeration date
03/03/2011
Last updated
06/15/2012
About Stedi
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