Healthcare Provider Details

I. General information

NPI: 1932016672
Provider Name (Legal Business Name): ANGELINA VALENZUELA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELINA VALENZUELA COHEN

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8640 SIERRA COLLEGE BLVD
ROSEVILLE CA
95661-5936
US

IV. Provider business mailing address

249 EL CAJON AVE
DAVIS CA
95616-0434
US

V. Phone/Fax

Practice location:
  • Phone: 916-783-2304
  • Fax: 916-783-2341
Mailing address:
  • Phone: 916-996-3966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number92895
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: