MEDICARE: MS. RICHELL GRACE VALDEZ SANEZ PT, DPT, CERT.DN

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	225100000X	Physical Therapist	3944	NV
2	225100000X	Physical Therapist	4348	NM
3	225100000X	Physical Therapist	PT295916	CA
4	225100000X	Physical Therapist	12726	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417302787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RICHELL GRACE VALDEZ SANEZ PT, DPT, CERT.DN

Provider Business Mailing Address
First Line	:	9628 WINDOM POINT AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7860
Country	:	US
Telephone Number	:	954-774-2241
Fax Number	:

Provider Business Practice Location Address
First Line	:	9628 WINDOM POINT AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7860
Country	:	US
Telephone Number	:	954-774-2241
Fax Number	:

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

Provider Enumeration Date	:	04/25/2016
Last Update Date	:	05/01/2026

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