Healthcare Provider Details

I. General information

NPI: 1851360671
Provider Name (Legal Business Name): VICTORIA CARLOS VALENA APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7430 WENTWORTH AVE
RICHFIELD MN
55423-4133
US

IV. Provider business mailing address

5204 14TH AVE S
MINNEAPOLIS MN
55417-1804
US

V. Phone/Fax

Practice location:
  • Phone: 612-488-0040
  • Fax: 833-973-4055
Mailing address:
  • Phone: 763-402-8738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10468
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number542
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: