Healthcare Provider Details

I. General information

NPI: 1538090535
Provider Name (Legal Business Name): CHRISTIAN VALENCIA PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 SUNSET WAY
HENDERSON NV
89014-2333
US

IV. Provider business mailing address

6275 BOULDER HWY APT 2019
LAS VEGAS NV
89122-7689
US

V. Phone/Fax

Practice location:
  • Phone: 702-968-6642
  • Fax:
Mailing address:
  • Phone: 951-214-9037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: