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NPI Code Detail

MEDICARE: MS. CHRISTINE VALENZUELA

MEDICARE: MS. CHRISTINE VALENZUELA
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1831249853
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTINE VALENZUELA
Provider Business Mailing Address
First Line : 330 W 10TH ST
Second Line :
City : SAN PEDRO
State : CA
Zip : 90731-3716
Country : US
Telephone Number : 310-847-0086
Fax Number :
Provider Business Practice Location Address
First Line : 1322 N AVALON BLVD
Second Line :
City : WILMINGTON
State : CA
Zip : 90744-2639
Country : US
Telephone Number : 310-513-1300
Fax Number : 310-513-1311
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2007
Last Update Date : 07/08/2007

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Practice Location Address:
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Directions to “ MS. CHRISTINE VALENZUELA ” Practice Location

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