MEDICARE: VALERIE LERMA

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	390200000X	Student in an Organized Health Care Education/Training Program		AZ
2	363A00000X	Physician Assistant		AZ

General Provider Information

NPI Number	:	1942969209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE LERMA

Provider Business Mailing Address
First Line	:	5812 N 63RD AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-5742
Country	:	US
Telephone Number	:	866-727-8274
Fax Number	:

Provider Business Practice Location Address
First Line	:	5812 N 63RD AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-5742
Country	:	US
Telephone Number	:	866-727-8274
Fax Number	:

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

Provider Enumeration Date	:	12/14/2021
Last Update Date	:	02/12/2026

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Directions to “ VALERIE LERMA ” Practice Location

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