MEDICARE: XITLALI J VALDEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		CA

General Provider Information

NPI Number	:	1063218204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	XITLALI J VALDEZ

Provider Business Mailing Address
First Line	:	742 W HIGHLAND AVE
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92405-3839
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7576 STERLING AVE STE C-D
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92410-4273
Country	:	US
Telephone Number	:	909-381-8983
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2025
Last Update Date	:	02/19/2025

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Directions to “ XITLALI J VALDEZ ” Practice Location

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