Provider Demographics
NPI:1578148730
Name:VALERIO, ALICIA (CPNP-AC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:VALERIO
Suffix:
Gender:F
Credentials:CPNP-AC
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:
Other - Last Name:VALERIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPNP-AC
Mailing Address - Street 1:747 52ND ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-1809
Mailing Address - Country:US
Mailing Address - Phone:510-428-3000
Mailing Address - Fax:
Practice Address - Street 1:747 52ND ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609
Practice Address - Country:US
Practice Address - Phone:510-428-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95015816363LP0200X, 363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP95015816OtherNURSE PRACTITIONER - CALIFORNIA