Provider Demographics
NPI:1780003400
Name:VALENZUELA TAKEOKA, ASHLEY DAVIS (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DAVIS
Last Name:VALENZUELA TAKEOKA
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1833 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-3043
Mailing Address - Country:US
Mailing Address - Phone:562-884-7599
Mailing Address - Fax:
Practice Address - Street 1:1535 RIVER PARK DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-4601
Practice Address - Country:US
Practice Address - Phone:916-734-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14223225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist