Provider Demographics
NPI:1477839462
Name:VALECRUZ, BLESS LOZA (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:BLESS LOZA
Middle Name:
Last Name:VALECRUZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 FAIRVIEW AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1632
Mailing Address - Country:US
Mailing Address - Phone:323-223-0082
Mailing Address - Fax:
Practice Address - Street 1:571 FAIRVIEW AVE APT 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1632
Practice Address - Country:US
Practice Address - Phone:323-223-0082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-23
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23034390200000X
CA68594183500000X
CA535891163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care