Healthcare Provider Details

I. General information

NPI: 1245154954
Provider Name (Legal Business Name): NATALIE SOFIA VALENZUELA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 GATEWAY BLVD
SOUTH SAN FRANCISCO CA
94080-7017
US

IV. Provider business mailing address

3146 OAK RD APT 5-207
WALNUT CREEK CA
94597-7717
US

V. Phone/Fax

Practice location:
  • Phone: 760-668-8879
  • Fax:
Mailing address:
  • Phone: 559-593-1501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: