Provider Demographics
NPI:1093841660
Name:VALENTI-MARTIN, CONSTANCE MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:MARIE
Last Name:VALENTI-MARTIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 SHANNON DR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-9241
Mailing Address - Country:US
Mailing Address - Phone:707-455-8856
Mailing Address - Fax:
Practice Address - Street 1:5555 GIANT HWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-6002
Practice Address - Country:US
Practice Address - Phone:510-262-4360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA615500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse