Provider Demographics
NPI:1578120713
Name:WILKINS, VALERIE C
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:C
Last Name:WILKINS
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 1:1040 S HALE AVE APT 49
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-2190
Mailing Address - Country:US
Mailing Address - Phone:619-634-9975
Mailing Address - Fax:
Practice Address - Street 1:8898 CLAIREMONT MESA BLVD STE H
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1127
Practice Address - Country:US
Practice Address - Phone:858-715-1211
Practice Address - Fax:858-715-1274
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CAR13222510918101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)