Provider Demographics
NPI:1093123192
Name:VALDEZ, VANESSA (LVN)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 N 1ST ST STE 162
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-6869
Mailing Address - Country:US
Mailing Address - Phone:559-274-0299
Mailing Address - Fax:844-563-6035
Practice Address - Street 1:3636 N 1ST ST STE 162
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-6869
Practice Address - Country:US
Practice Address - Phone:559-476-2166
Practice Address - Fax:844-563-6035
Is Sole Proprietor?:No
Enumeration Date:2014-08-01
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN255465164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse