Healthcare Provider Details

I. General information

NPI: 1659252476
Provider Name (Legal Business Name): ALEXANDRA VALENCIA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W F ST
ONTARIO CA
91762-3207
US

IV. Provider business mailing address

12666 KUMQUAT AVE
CHINO CA
91710-3840
US

V. Phone/Fax

Practice location:
  • Phone: 909-988-9288
  • Fax:
Mailing address:
  • Phone: 909-762-6626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95036901
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: