Healthcare Provider Details

I. General information

NPI: 1245236934
Provider Name (Legal Business Name): AMBER ANN VALENCIA-CAMPBELL D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 MISSION GORGE RD STE L
SANTEE CA
92071-3026
US

IV. Provider business mailing address

10201 MISSION GORGE RD STE L
SANTEE CA
92071-3026
US

V. Phone/Fax

Practice location:
  • Phone: 619-449-8100
  • Fax: 619-258-2010
Mailing address:
  • Phone: 619-449-8100
  • Fax: 619-258-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC28865
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: