Healthcare Provider Details

I. General information

NPI: 1053267237
Provider Name (Legal Business Name): DANNY VALDEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9608 VENICE BLVD
CULVER CITY CA
90232-2626
US

IV. Provider business mailing address

6541 RUGBY AVE UNIT D
HUNTINGTON PARK CA
90255-6904
US

V. Phone/Fax

Practice location:
  • Phone: 323-986-9714
  • Fax:
Mailing address:
  • Phone: 213-806-9945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number6903
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: