Provider Demographics
NPI:1710540240
Name:VAN TUINEN, VALERIE DENISE (BHS)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:DENISE
Last Name:VAN TUINEN
Suffix:
Gender:F
Credentials:BHS
Other - Prefix:MRS
Other - First Name:VALERIE
Other - Middle Name:DENISE
Other - Last Name:VAN TUINEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BHS
Mailing Address - Street 1:1904 RICHLAND AVE # C-2
Mailing Address - Street 2:
Mailing Address - City:CERES
Mailing Address - State:CA
Mailing Address - Zip Code:95307-4562
Mailing Address - Country:US
Mailing Address - Phone:209-558-4600
Mailing Address - Fax:209-541-2549
Practice Address - Street 1:1904 RICHLAND AVE # C-2
Practice Address - Street 2:
Practice Address - City:CERES
Practice Address - State:CA
Practice Address - Zip Code:95307-4562
Practice Address - Country:US
Practice Address - Phone:209-558-4600
Practice Address - Fax:209-541-2549
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2023-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC1734596374700000X
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No374700000XNursing Service Related ProvidersTechnician