Provider Demographics
NPI:1376149674
Name:FLEETON, AUREALIUS VALENCINO I (PTA)
Entity Type:Individual
Prefix:MR
First Name:AUREALIUS
Middle Name:VALENCINO
Last Name:FLEETON
Suffix:I
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7323 WASHINGTON PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-8288
Mailing Address - Country:US
Mailing Address - Phone:909-476-0101
Mailing Address - Fax:
Practice Address - Street 1:7323 WASHINGTON PL
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-8288
Practice Address - Country:US
Practice Address - Phone:909-476-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9407225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant