Healthcare Provider Details

I. General information

NPI: 1932961661
Provider Name (Legal Business Name): KEREN VALENCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 ROSSMOOR PKWY
WALNUT CREEK CA
94595-2538
US

IV. Provider business mailing address

1873 W TRAVERSE PKWY STE E100
LEHI UT
84048-5985
US

V. Phone/Fax

Practice location:
  • Phone: 801-215-9309
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95028825
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95028825
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95028825
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: