Provider Demographics
NPI:1336764091
Name:VALLEDOR, JANICE FLORIA (RN)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:FLORIA
Last Name:VALLEDOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:FLORIA
Other - Last Name:VALLEDOR ALAMEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1350 W COVINA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-3245
Mailing Address - Country:US
Mailing Address - Phone:909-599-6811
Mailing Address - Fax:
Practice Address - Street 1:1350 W COVINA BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-3245
Practice Address - Country:US
Practice Address - Phone:909-599-6811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA747524163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency