Healthcare Provider Details

I. General information

NPI: 1043135387
Provider Name (Legal Business Name): MARTHA JANETH LEYVA VALENZUELA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1763 W 24TH ST STE 100
YUMA AZ
85364-6219
US

IV. Provider business mailing address

1763 W 24TH ST STE 100
YUMA AZ
85364-6219
US

V. Phone/Fax

Practice location:
  • Phone: 928-318-2022
  • Fax: 928-569-5114
Mailing address:
  • Phone: 928-318-2022
  • Fax: 928-569-5114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: