Healthcare Provider Details

I. General information

NPI: 1578148730
Provider Name (Legal Business Name): ALICIA VALERIO CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICIA VALERIO CPNP-AC

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 06/27/2021
Certification Date: 06/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST
OAKLAND CA
94609
US

IV. Provider business mailing address

747 52ND ST
OAKLAND CA
94609-1809
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3000
  • Fax:
Mailing address:
  • Phone: 510-428-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNP95015816
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberNP95015816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: