Healthcare Provider Details

I. General information

NPI: 1063331734
Provider Name (Legal Business Name): CELESTE LEA VALDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6836 36TH STREET
JURUPA VALLEY CA
92509
US

IV. Provider business mailing address

6836 36TH ST
JURUPA VALLEY CA
92509-1307
US

V. Phone/Fax

Practice location:
  • Phone: 909-230-0510
  • Fax:
Mailing address:
  • Phone: 909-230-0510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: