Provider Demographics
NPI:1760983415
Name:VALDEZ GUZMAN, ALEJANDRA MARIVEL
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:MARIVEL
Last Name:VALDEZ GUZMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3603 BASTROP ST
Mailing Address - Street 2:2
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004
Mailing Address - Country:US
Mailing Address - Phone:909-275-8506
Mailing Address - Fax:
Practice Address - Street 1:411 DURHAM DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-7240
Practice Address - Country:US
Practice Address - Phone:713-861-4849
Practice Address - Fax:713-867-7742
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1082311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA90479470D84149OtherIEHP