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NPI Code Detail

MEDICARE: ERIC JOSEPH VALENCIA

MEDICARE: ERIC JOSEPH VALENCIA
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1548840069
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC JOSEPH VALENCIA
Provider Business Mailing Address
First Line : 713 N CORBIN ST
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-6309
Country : US
Telephone Number : 575-590-5037
Fax Number :
Provider Business Practice Location Address
First Line : 1120 N WEST ST
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-4600
Country : US
Telephone Number : 575-654-0576
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2021
Last Update Date : 04/09/2021

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Directions to “ ERIC JOSEPH VALENCIA ” Practice Location

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