Provider Demographics
NPI:1598308801
Name:VALENCIA HEALTH AND WELLNESS, P.C
Entity Type:Organization
Organization Name:VALENCIA HEALTH AND WELLNESS, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:TAFOYA
Authorized Official - Last Name:TRUJILLO
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:505-249-4456
Mailing Address - Street 1:101 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BELEN
Mailing Address - State:NM
Mailing Address - Zip Code:87002-3605
Mailing Address - Country:US
Mailing Address - Phone:505-317-7773
Mailing Address - Fax:855-844-8611
Practice Address - Street 1:101 N 6TH ST
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002-3605
Practice Address - Country:US
Practice Address - Phone:505-317-7773
Practice Address - Fax:855-844-8611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty