Healthcare Provider Details

I. General information

NPI: 1801642939
Provider Name (Legal Business Name): VALERIA ALTUZAR-RENTERIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

892 27TH ST
SAN DIEGO CA
92154-1444
US

IV. Provider business mailing address

892 27TH ST
SAN DIEGO CA
92154-1444
US

V. Phone/Fax

Practice location:
  • Phone: 619-575-4687
  • Fax:
Mailing address:
  • Phone: 619-575-4687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number21438
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: