Provider Demographics
NPI:1609537745
Name:TANALEON, MICHELLE VALERIO (FNP-C)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:VALERIO
Last Name:TANALEON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8112 MILLIKEN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-7473
Mailing Address - Country:US
Mailing Address - Phone:909-466-7337
Mailing Address - Fax:
Practice Address - Street 1:8112 MILLIKEN AVE STE 201
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7473
Practice Address - Country:US
Practice Address - Phone:909-466-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-30
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019537363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily