Provider Demographics
NPI:1306384987
Name:VALENCIA, LOVELLE CHRISTINE (NP)
Entity Type:Individual
Prefix:
First Name:LOVELLE CHRISTINE
Middle Name:
Last Name:VALENCIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LOVELLE
Other - Middle Name:
Other - Last Name:VALENCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:23150 AVENUE SAN LUIS
Mailing Address - Street 2:APT 209
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1037
Mailing Address - Country:US
Mailing Address - Phone:818-741-7436
Mailing Address - Fax:818-334-5376
Practice Address - Street 1:6856 PETIT AVE
Practice Address - Street 2:
Practice Address - City:LAKE BALBOA
Practice Address - State:CA
Practice Address - Zip Code:91406-4614
Practice Address - Country:US
Practice Address - Phone:818-741-7436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-03
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005991363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily