Provider Demographics
NPI:1508621350
Name:CORREA, VALERIA LIZETH (NP)
Entity Type:Individual
Prefix:
First Name:VALERIA
Middle Name:LIZETH
Last Name:CORREA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 EL DORADO DR
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:CA
Mailing Address - Zip Code:93510-1808
Mailing Address - Country:US
Mailing Address - Phone:818-259-1074
Mailing Address - Fax:
Practice Address - Street 1:23101 SHERMAN PL
Practice Address - Street 2:STE 301
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2010
Practice Address - Country:US
Practice Address - Phone:818-523-9640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028639363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology