Provider Demographics
NPI:1316561756
Name:VALENZUELA, LUZ
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:
Last Name:VALENZUELA
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 1:22314 COHASSET ST
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1033
Mailing Address - Country:US
Mailing Address - Phone:818-310-5740
Mailing Address - Fax:
Practice Address - Street 1:9745 LAUREL CANYON BLVD STE A
Practice Address - Street 2:
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-4115
Practice Address - Country:US
Practice Address - Phone:818-869-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant