Individual provider Active NPI

Jennifer Vallely, MA ED., MS

  • Mental Health Counselor
  • Yucca Valley, CA
National Provider Identifier
1114730827
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
APCC17691 Issued in CA
Practice address
58457 Twentynine Palms Hwy
Ste 102 a
Yucca Valley, CA 92284
Phone
(760) 228-9657
NPI assigned
Jan 28, 2025
Last updated
Jan 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X APCC17691 CA Primary

Addresses

Primary practice location

58457 Twentynine Palms Hwy
Ste 102 a
Yucca Valley, CA 92284

Mailing address

PO Box 158
Mentone, CA 92359-0158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
APCC17691CAMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1114730827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "MENTONE",
            "state": "CA",
            "postal_code": "923590158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58457 TWENTYNINE PALMS HWY",
            "address_2": "STE 102 A",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "92284",
            "telephone_number": "760-228-9657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLELY",
        "first_name": "JENNIFER",
        "credential": "MA ED., MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "APCC17691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucca Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.