MEDICARE: SANDRA VALENZUELA

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	172V00000X	Community Health Worker
2	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1396047049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA VALENZUELA

Provider Business Mailing Address
First Line	:	3756 SANTA ROSALIA DR STE 424
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-3614
Country	:	US
Telephone Number	:	323-596-3147
Fax Number	:	323-596-3473

Provider Business Practice Location Address
First Line	:	3756 SANTA ROSALIA DR STE 424
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-3614
Country	:	US
Telephone Number	:	323-596-3147
Fax Number	:	323-596-3473

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

Provider Enumeration Date	:	12/01/2010
Last Update Date	:	06/17/2025

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Directions to “ SANDRA VALENZUELA ” Practice Location

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