Provider Demographics
NPI:1821795691
Name:VALADEZ, SOPHIA (HAD)
Entity Type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:
Last Name:VALADEZ
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:MS
Other - First Name:SOPHIA
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HAT
Mailing Address - Street 1:2654 GRIFFITH PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039
Mailing Address - Country:US
Mailing Address - Phone:323-906-1275
Mailing Address - Fax:
Practice Address - Street 1:2654 GRIFFITH PARK BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-2520
Practice Address - Country:US
Practice Address - Phone:323-906-1275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10331237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist