Healthcare Provider Details

I. General information

NPI: 1033852009
Provider Name (Legal Business Name): MICHELLE VALDES ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 04/18/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15770 SAN ANDRES DR
DEL MAR CA
92014-1914
US

IV. Provider business mailing address

310 DEL SOL DR APT 449
SAN DIEGO CA
92108-2972
US

V. Phone/Fax

Practice location:
  • Phone: 619-755-5398
  • Fax:
Mailing address:
  • Phone: 347-409-5685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND1314
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: