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General NPI Number Information
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NPI Number | 1972840338
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Entity Type | Individual
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Provider Name | LORENA DEL VALLE P.A.
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Gender | Female
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Dates
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Enumeration Date | 01/04/2013
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Last Update Date | 01/04/2013
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Provider Practice Location Address
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Address Line | 24035 NEWHALL RANCH RD
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City | SANTA CLARITA
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State | CA
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Zip | 91355-5702
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Country | US
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Telephone | 661-661-2913
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Fax | 661-661-2913
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Provider Business Mailing Address
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Address Line | 5315 TORRANCE BLVD
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City | TORRANCE
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State | CA
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Zip | 90503-4011
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Country | US
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Telephone | 310-543-7026
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Fax | 310-543-7093
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA22072
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License Number State | CA
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