Provider Demographics
NPI:1457892101
Name:VALENCIA, JOYCE (NP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:VALENCIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 S WHITE RD
Mailing Address - Street 2:#50
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2076
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2690 S WHITE RD STE 50
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148
Practice Address - Country:US
Practice Address - Phone:408-223-7000
Practice Address - Fax:408-223-7001
Is Sole Proprietor?:No
Enumeration Date:2017-03-14
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005433363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF1116341OtherFAMILY NURSE PRACTITIONER CERTIFICATION