Provider Demographics
NPI:1689717282
Name:VALENSKY, VICTORIA LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNN
Last Name:VALENSKY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29812 ANDREA WAY
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1741
Mailing Address - Country:US
Mailing Address - Phone:949-463-1715
Mailing Address - Fax:949-495-9609
Practice Address - Street 1:29812 ANDREA WAY
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1741
Practice Address - Country:US
Practice Address - Phone:949-463-1715
Practice Address - Fax:949-495-9609
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA498977363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA688AOtherMEDICARE PTAN
CANP10746Medicare PIN
CACA688AMedicare PIN
CACA688AOtherMEDICARE PTAN