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General NPI Number Information
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NPI Number | 1548819964
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Entity Type | Individual
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Provider Name | MYRA VALENCIA NP
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Gender | Female
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 2240 E GONZALES RD STE 110
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City | OXNARD
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State | CA
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Zip | 93036-8212
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Country | US
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Telephone | 805-981-5161
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10818
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City | SAN BERNARDINO
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State | CA
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Zip | 92423-0818
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 95012501
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License Number State | CA
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