Healthcare Provider Details

I. General information

NPI: 1023981230
Provider Name (Legal Business Name): VALERIE VALENCIA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10345 PROFESSIONAL CIR STE 125
RENO NV
89521-3100
US

IV. Provider business mailing address

3176 TEDESCO CT
SPARKS NV
89434-9131
US

V. Phone/Fax

Practice location:
  • Phone: 916-706-8199
  • Fax:
Mailing address:
  • Phone: 916-706-8199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number26-519589
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: