MEDICARE: MS. NATTALY VALENZUELA-MEZA

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	1041C0700X	Clinical Social Worker	ASW 24833	CA
2	1041C0700X	Clinical Social Worker	60954	CA

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	:	1811133416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NATTALY VALENZUELA-MEZA

Provider Business Mailing Address
First Line	:	7365 CARNELIAN ST STE 231
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-1136
Country	:	US
Telephone Number	:	626-430-0177
Fax Number	:

Provider Business Practice Location Address
First Line	:	7365 CARNELIAN ST STE 231
Second Line	:
City	:	RANCHO CUCAMONGA
State	:	CA
Zip	:	91730-1136
Country	:	US
Telephone Number	:	626-430-0177
Fax Number	:

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

Provider Enumeration Date	:	01/02/2009
Last Update Date	:	04/04/2025

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