Provider Demographics
NPI:1780018804
Name:VALCOURT, SAMANTHA (RN, CNS)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:VALCOURT
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 QUARRY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1416
Mailing Address - Country:US
Mailing Address - Phone:650-724-1800
Mailing Address - Fax:650-736-2550
Practice Address - Street 1:211 QUARRY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1416
Practice Address - Country:US
Practice Address - Phone:650-724-1800
Practice Address - Fax:650-736-2550
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA647530163W00000X
CA3826364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163W00000XNursing Service ProvidersRegistered Nurse