Provider Demographics
NPI:1124536271
Name:SURLES, VALARIE RUTH
Entity Type:Individual
Prefix:
First Name:VALARIE
Middle Name:RUTH
Last Name:SURLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42112 JENNY LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-7462
Mailing Address - Country:US
Mailing Address - Phone:661-817-8479
Mailing Address - Fax:
Practice Address - Street 1:42112 JENNY LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-7462
Practice Address - Country:US
Practice Address - Phone:661-817-8479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-10
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267762164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse