Healthcare Provider Details

I. General information

NPI: 1538539721
Provider Name (Legal Business Name): DORINA VALEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 09/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9102 W WHITE FEATHER LN
PEORIA AZ
85383-4635
US

IV. Provider business mailing address

9102 W WHITE FEATHER LN
PEORIA AZ
85383-4635
US

V. Phone/Fax

Practice location:
  • Phone: 623-266-3574
  • Fax:
Mailing address:
  • Phone: 623-266-3574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberAL9725H
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: