Healthcare Provider Details

I. General information

NPI: 1174238356
Provider Name (Legal Business Name): CANDACE MAE VALENZUELA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 PAGE MILL RD STE 103
PALO ALTO CA
94306-2073
US

IV. Provider business mailing address

195 PAGE MILL RD STE 103
PALO ALTO CA
94306-2073
US

V. Phone/Fax

Practice location:
  • Phone: 888-731-8994
  • Fax:
Mailing address:
  • Phone: 888-713-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95023716
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: