Healthcare Provider Details

I. General information

NPI: 1144014689
Provider Name (Legal Business Name): CINDY VALERIA VALDEZ COBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3532 MONROE ST
RIVERSIDE CA
92504-6322
US

IV. Provider business mailing address

7404 PHILBIN AVE APT 13
RIVERSIDE CA
92503-1979
US

V. Phone/Fax

Practice location:
  • Phone: 877-228-3615
  • Fax:
Mailing address:
  • Phone: 951-429-2712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: