Healthcare Provider Details

I. General information

NPI: 1942099031
Provider Name (Legal Business Name): DENISSE GUADALUPE VALDEZ MUNOZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 POLLASKY AVE
CLOVIS CA
93612-1159
US

IV. Provider business mailing address

583 S PACHECO DR
KERMAN CA
93630-1531
US

V. Phone/Fax

Practice location:
  • Phone: 559-203-3775
  • Fax:
Mailing address:
  • Phone: 559-567-8688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: