Provider Demographics
NPI:1497468938
Name:VALENZUELA, PAULA (RDH)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:ORSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:1751 ASKREN CT
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-2222
Mailing Address - Country:US
Mailing Address - Phone:209-814-4822
Mailing Address - Fax:
Practice Address - Street 1:1751 ASKREN CT
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-2222
Practice Address - Country:US
Practice Address - Phone:209-814-4822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-29
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23947124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist