Provider Demographics
NPI:1598381410
Name:HOSHIZAKI, VALERIE LAM (OD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:LAM
Last Name:HOSHIZAKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:KATE
Other - Last Name:LAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:14 W SIERRA MADRE BLVD
Mailing Address - Street 2:
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024-2434
Mailing Address - Country:US
Mailing Address - Phone:626-507-2724
Mailing Address - Fax:
Practice Address - Street 1:14 W SIERRA MADRE BLVD
Practice Address - Street 2:
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024-2434
Practice Address - Country:US
Practice Address - Phone:626-507-2724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA34529152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program