Provider Demographics
NPI:1033852009
Name:VALDES, MICHELLE (ND)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:VALDES
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 DEL SOL DR APT 449
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-2972
Mailing Address - Country:US
Mailing Address - Phone:347-409-5685
Mailing Address - Fax:
Practice Address - Street 1:15770 SAN ANDRES DR
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-1914
Practice Address - Country:US
Practice Address - Phone:619-755-5398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND1314175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath