Healthcare Provider Details

I. General information

NPI: 1871148494
Provider Name (Legal Business Name): TAYLOR ANN VALENZA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2019
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3418 LOMA VISTA RD STE A
VENTURA CA
93003-3015
US

IV. Provider business mailing address

3418 LOMA VISTA RD STE A
VENTURA CA
93003-3015
US

V. Phone/Fax

Practice location:
  • Phone: 805-410-1363
  • Fax:
Mailing address:
  • Phone: 805-410-1363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number296961
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: