Provider Demographics
NPI:1417535055
Name:MATA, VALERIE MARIE (CASE MANAGER)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:MARIE
Last Name:MATA
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 S COUNTRY CLUB RD STE 130
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85714-2203
Mailing Address - Country:US
Mailing Address - Phone:520-874-2778
Mailing Address - Fax:520-874-6091
Practice Address - Street 1:3950 S COUNTRY CLUB RD STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-2226
Practice Address - Country:US
Practice Address - Phone:520-874-2778
Practice Address - Fax:520-874-6091
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator