Provider Demographics
NPI:1134454416
Name:VALENCIA, IRENE JOY (ND)
Entity type:Individual
Prefix:DR
First Name:IRENE
Middle Name:JOY
Last Name:VALENCIA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-3761
Mailing Address - Country:US
Mailing Address - Phone:831-477-1377
Mailing Address - Fax:831-477-0425
Practice Address - Street 1:736 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-3761
Practice Address - Country:US
Practice Address - Phone:831-477-1377
Practice Address - Fax:831-477-0425
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND-372175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath