Provider Demographics
NPI:1114154747
Name:VALJALO, ELIZABETH ANNE (RN, MSN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANNE
Last Name:VALJALO
Suffix:
Gender:F
Credentials:RN, MSN, FNP
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:SHERWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, MSN, FNP
Mailing Address - Street 1:5925 W LAS POSITAS BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-8537
Mailing Address - Country:US
Mailing Address - Phone:925-201-6011
Mailing Address - Fax:925-417-1503
Practice Address - Street 1:1500 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4408
Practice Address - Country:US
Practice Address - Phone:209-574-1365
Practice Address - Fax:209-574-1372
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18966363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily