Healthcare Provider Details

I. General information

NPI: 1053106427
Provider Name (Legal Business Name): ASHLEY VALDIVIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25109 JEFFERSON AVE STE 200
MURRIETA CA
92562-8117
US

IV. Provider business mailing address

25109 JEFFERSON AVE STE 200
MURRIETA CA
92562-8117
US

V. Phone/Fax

Practice location:
  • Phone: 951-297-7773
  • Fax:
Mailing address:
  • Phone: 951-297-7773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number135089
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number686152
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: