Provider Demographics
NPI:1225751274
Name:EGUASA, VALERIE OSAYEMWENRE
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:OSAYEMWENRE
Last Name:EGUASA
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 1:16147 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2560
Mailing Address - Country:US
Mailing Address - Phone:562-902-2273
Mailing Address - Fax:
Practice Address - Street 1:1265 FLINT DR
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-3446
Practice Address - Country:US
Practice Address - Phone:912-248-5760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily