Provider Demographics
NPI:1629268180
Name:VALENZUELA, LINDSEY HERNANDEZ (PHARM D)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:HERNANDEZ
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68860 PEREZ RD STE J
Mailing Address - Street 2:CATHEDRAL CITY
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-7248
Mailing Address - Country:US
Mailing Address - Phone:760-328-4499
Mailing Address - Fax:760-328-2230
Practice Address - Street 1:35325 DATE PALM DR. #209
Practice Address - Street 2:CATHEDRAL CITY
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-7248
Practice Address - Country:US
Practice Address - Phone:760-328-4499
Practice Address - Fax:760-328-2230
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ26628ZMedicare PIN