Provider Demographics
NPI:1225102858
Name:SIMOES, VALERIE C (PA)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:C
Last Name:SIMOES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:12550 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EL MIRAGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85335-4918
Mailing Address - Country:US
Mailing Address - Phone:623-556-8860
Mailing Address - Fax:623-876-9559
Practice Address - Street 1:2204 S DOBSON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-6457
Practice Address - Country:US
Practice Address - Phone:480-491-6235
Practice Address - Fax:480-491-6239
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3475363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical