Provider Demographics
NPI:1225586597
Name:VALDEZ, DANIEL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4930 W KAWEAH CT
Mailing Address - Street 2:SUITE 203
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-8324
Mailing Address - Country:US
Mailing Address - Phone:559-713-6806
Mailing Address - Fax:559-713-6809
Practice Address - Street 1:1401 W EL MONTE WAY
Practice Address - Street 2:107
Practice Address - City:DINUBA
Practice Address - State:CA
Practice Address - Zip Code:93618-9165
Practice Address - Country:US
Practice Address - Phone:559-315-5203
Practice Address - Fax:559-315-5180
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT292030225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist