Healthcare Provider Details
I. General information
NPI: 1699797027
Provider Name (Legal Business Name): VALERIE JOSEPHSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/24/2006
Last Update Date: 08/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2 UPPER RAGSDALE DR SUITE B-210
MONTEREY CA
93940-5736
US
IV. Provider business mailing address
2 UPPER RAGSDALE DR SUITE B-210
MONTEREY CA
93940-5736
US
V. Phone/Fax
- Phone: 831-333-0999
- Fax: 831-333-0909
- Phone: 831-333-0999
- Fax: 831-333-0909
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | A63482 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: