Provider Demographics
NPI:1477156032
Name:BEN F VALDEZ MD INC
Entity Type:Organization
Organization Name:BEN F VALDEZ MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:VENIECE
Authorized Official - Middle Name:
Authorized Official - Last Name:DELLY
Authorized Official - Suffix:
Authorized Official - Credentials:PNP
Authorized Official - Phone:916-773-5577
Mailing Address - Street 1:508 GIBSON DR STE 220
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5796
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:508 GIBSON DR STE 220
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-5796
Practice Address - Country:US
Practice Address - Phone:916-773-5577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care