Healthcare Provider Details

I. General information

NPI: 1548331069
Provider Name (Legal Business Name): PATRICIA VALBUENA DAHLBERG RN, PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CLAUDIA PATRICIA VALBUENA RN, PNP

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W 7TH ST
SAN PEDRO CA
90732-3505
US

IV. Provider business mailing address

2265 ESTRIBO DR
ROLLING HILLS ESTATES CA
90274-5111
US

V. Phone/Fax

Practice location:
  • Phone: 310-514-5465
  • Fax: 310-514-5478
Mailing address:
  • Phone: 310-548-0205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN#221764
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: