=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629992995
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID C VALENCIA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/07/2026
-----------------------------------------------------
Last Update Date | 08/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2069 MULLINS AVENUE #109
-----------------------------------------------------
City | ALAMOSA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-527-0142
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2069 MULLINS AVENUE 109
-----------------------------------------------------
City | ALAMOSA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 909-527-0142
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number | RBT-26-514888
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------