Individual
DR. JESSICA MARIE VALENCIA-FAGOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
7509 MENCHACA RD UNIT 109, AUSTIN, TX 78745-6050
(512) 643-5101
(833) 594-1316
Mailing address
7509 MENCHACA RD UNIT 109, AUSTIN, TX 78745-6050
(512) 643-5101
(833) 594-1316
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
38205
TX
390200000X
Student in an Organized Health Care Education/Training Program
D4627793
CA
Other
Enumeration date
04/17/2014
Last updated
08/16/2021
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