Healthcare Provider Details

I. General information

NPI: 1609714542
Provider Name (Legal Business Name): VALEN PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 RAY AVE
FAYETTEVILLE NC
28301-4916
US

IV. Provider business mailing address

4240 PLEASANTBURG DR
FAYETTEVILLE NC
28312-7637
US

V. Phone/Fax

Practice location:
  • Phone: 910-432-0741
  • Fax:
Mailing address:
  • Phone: 910-624-7986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberE31308
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: