MR. DAVID GREGORY VALLEY (NPI# 1669770426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669770426 |
| Entity Type | Individual |
| Full Name | MR. DAVID GREGORY VALLEY |
| Credential | CSAC, CLA |
| Practice Address |
3258 North State Street Ukiah CA 95482-3052 |
| Practice Telephone | 7072349472 |
| Practice Fax Number | 7074632045 |
| Mailing Telephone | 7072349472 |
| Mailing Fax Number | 7074632045 |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2012-06-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 1135-031613A | CA | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1135-031613A | CA | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CORPHQ-1135-0316 | CA | Behavioral Health & Social Service Providers |
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NATIONWIDE INSURANC | DMR0616 | 01 | |
| CA | AOD LICENSE | 1135-031613A | 01 |
| IRS TAX ID | 45-4980495 | 01 |
| Street Address |
3258 NORTH STATE STREET |
| City | UKIAH |
| State | CA |
| Zip Code | 95482-3052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726726 | Gloria Gonzalez Campise | Midwife | 205 W. Clay Street, Ukiah, CA 95482 | 2020-06-29 |
| 1083255095 | Mendocino Care Network | Internal Medicine | 1080 N State St, Ukiah, CA 95482 | 2019-10-01 |
| 1801383153 | Costco Wholesale Corporation | Pharmacy | 1275 Airport Park Blvd., Ukiah, CA 95482 | 2018-04-21 |
| 1922528256 | Ian David Winter | Case Manager/Care Coordinator | 1120 S. Dora St, Ukiah, CA 95482 | 2017-06-27 |
| 1568917938 | Rebecca Ann Dragomani | Nurse Practitioner | 260 Hospital Dr Ste 101, Ukiah, CA 95482 | 2016-08-16 |
| 1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
| 1689061061 | Pamela Mathias | Counselor | 367 East Gobbi Street, Suite E, Ukiah, CA 95482 | 2015-04-23 |
| 1275927030 | Jack David Segel | Counselor | 564 Dora St., Ste.d, Ukiah, CA 95482 | 2015-03-19 |
| 1689070211 | Mendocino County Youth Project | Clinic/Center | 347 Plum St, #b, Ukiah, CA 95482 | 2014-11-10 |
| 1346649951 | Ae Ran Ku | Dentist | 1096 South Dora Street, Ukiah, CA 95482 | 2014-08-19 |
| Find all providers in zip 95482 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437662954 | Elliot Ward | Counselor | 501 Peach St, Ukiah, CA 95482-4516 | 2017-11-06 |
| 1912457557 | Mariah Hunt | Counselor | 564 S Dora St Ste 2, Apt H, Ukiah, CA 95482-5486 | 2016-10-06 |
| 1487058566 | Chelsea Akin | Counselor | 1690 Woodland Ter, Ukiah, CA 95482-5254 | 2014-10-17 |
| 1477979219 | Tom Buske | Counselor | 205 N Bush St, Ukiah, CA 95482-4361 | 2014-03-17 |
| 1023434362 | Bonnie Lockhart | Counselor | 810 N State St, Ukiah, CA 95482-3410 | 2014-03-11 |
| 1285936385 | Sarah A Livingston | Counselor | 350 E Gobbi St Ste B2, Ukiah, CA 95482-5511 | 2010-11-22 |
| 1841443389 | William Armstrong | Counselor | 780 S Dora St, Ukiah, CA 95482-5348 | 2008-10-28 |
| 1588794366 | Donna Lee Matthews | Counselor | 270 N Pine St, Ukiah, CA 95482-4334 | 2007-03-07 |
| 1730229675 | Carmen J Harris | Counselor | 140 Gibson St, Ukiah, CA 95482-3941 | 2007-02-08 |
| 1225182470 | Mendocino County Youth Project | Counselor | 776 S State St, #107, Ukiah, CA 95482 | 2007-01-23 |
| Find all providers in UKIAH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.