Provider Demographics
NPI:1093458556
Name:ESPINOZA VALENCIA, ADRIANA CAMILIA
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:CAMILIA
Last Name:ESPINOZA VALENCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AYDREE
Other - Middle Name:
Other - Last Name:VALENCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:30552 PARADISE PALM AVE
Mailing Address - Street 2:
Mailing Address - City:HOMELAND
Mailing Address - State:CA
Mailing Address - Zip Code:92548-9550
Mailing Address - Country:US
Mailing Address - Phone:909-528-5748
Mailing Address - Fax:
Practice Address - Street 1:24081 SANDY GLADE AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557-5529
Practice Address - Country:US
Practice Address - Phone:951-223-1283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician