MEDICARE: ROSEANNE VALDEZ-HUGHES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4779	OTHER	CA	SIMON STAFF NUMBER

General Provider Information

NPI Number	:	1093910580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEANNE VALDEZ-HUGHES

Provider Business Mailing Address
First Line	:	PO BOX 7369
Second Line	:
City	:	REDLANDS
State	:	CA
Zip	:	92375-0369
Country	:	US
Telephone Number	:	909-335-7067
Fax Number	:	909-792-2045

Provider Business Practice Location Address
First Line	:	34324 YUCAIPA BLVD
Second Line	:	SUITE B
City	:	YUCAIPA
State	:	CA
Zip	:	92399-2496
Country	:	US
Telephone Number	:	909-790-1300
Fax Number	:	909-797-9687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	07/08/2007

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Directions to “ ROSEANNE VALDEZ-HUGHES ” Practice Location

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