Provider Demographics
NPI:1235607292
Name:VALENZUELA, AMBER LEEANN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:LEEANN
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2657 E PUEBLO AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-3805
Mailing Address - Country:US
Mailing Address - Phone:480-688-7503
Mailing Address - Fax:
Practice Address - Street 1:8415 N PIMA RD STE 175
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4484
Practice Address - Country:US
Practice Address - Phone:480-961-2365
Practice Address - Fax:480-961-2382
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7571363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant