Healthcare Provider Details

I. General information

NPI: 1255235867
Provider Name (Legal Business Name): EDNA VALDERRAMA MSN,RN,PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 RAPALLO CT
BAY POINT CA
94565-6743
US

IV. Provider business mailing address

31 RAPALLO CT
BAY POINT CA
94565-6743
US

V. Phone/Fax

Practice location:
  • Phone: 702-515-9211
  • Fax:
Mailing address:
  • Phone: 702-515-9211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2026094616
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2026094616
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: