Provider Demographics
NPI:1417386756
Name:VALERIO, REGALADO ANGELO JR (CRNA)
Entity Type:Individual
Prefix:MR
First Name:REGALADO
Middle Name:ANGELO
Last Name:VALERIO
Suffix:JR
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23953 RUSTICO CT
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-1559
Mailing Address - Country:US
Mailing Address - Phone:310-880-7341
Mailing Address - Fax:
Practice Address - Street 1:23953 RUSTICO CT
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91354-1559
Practice Address - Country:US
Practice Address - Phone:310-880-7341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA713419163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse