Provider Demographics
NPI:1407382757
Name:SPALDING, VALERIE LYNN (NP)
Entity Type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:LYNN
Last Name:SPALDING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27200 IRIS AVE
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-4803
Mailing Address - Country:US
Mailing Address - Phone:951-251-6224
Mailing Address - Fax:
Practice Address - Street 1:29998 WINDWARD DR
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:CA
Practice Address - Zip Code:92587-7481
Practice Address - Country:US
Practice Address - Phone:951-893-8212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-05
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006558363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily