Healthcare Provider Details

I. General information

NPI: 1093690968
Provider Name (Legal Business Name): BEATRIZ ADRIANA VALENCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1752 E BULLARD AVE STE 101
FRESNO CA
93710-5864
US

IV. Provider business mailing address

1752 E BULLARD AVE STE 101
FRESNO CA
93710-5864
US

V. Phone/Fax

Practice location:
  • Phone: 559-970-8277
  • Fax:
Mailing address:
  • Phone: 559-970-8277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number9822
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: