Healthcare Provider Details

I. General information

NPI: 1144054990
Provider Name (Legal Business Name): PEREZ VAN VALZAH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 ENCINITAS BLVD STE 301A
ENCINITAS CA
92024-3762
US

IV. Provider business mailing address

681 ENCINITAS BLVD STE 301A
ENCINITAS CA
92024-3762
US

V. Phone/Fax

Practice location:
  • Phone: 858-392-8200
  • Fax:
Mailing address:
  • Phone: 858-392-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM VAN VALZAH
Title or Position: OWNER
Credential:
Phone: 858-392-8200