MEDICARE: LOREN FERNANDEZ VALENTIN

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	1041C0700X	Clinical Social Worker		PA

General Provider Information

NPI Number	:	1538015763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOREN FERNANDEZ VALENTIN

Provider Business Mailing Address
First Line	:	1837 N 17TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19121-3565
Country	:	US
Telephone Number	:	504-380-5208
Fax Number	:

Provider Business Practice Location Address
First Line	:	1837 N 17TH ST UNIT B
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19121-3565
Country	:	US
Telephone Number	:	504-380-5208
Fax Number	:

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

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “ LOREN FERNANDEZ VALENTIN ” Practice Location

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