Provider Demographics
NPI:1699497909
Name:VALERIO, NADEZNA JOELLE RICAPLAZA (PT)
Entity type:Individual
Prefix:MS
First Name:NADEZNA JOELLE
Middle Name:RICAPLAZA
Last Name:VALERIO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NADEZNA JOELLE
Other - Middle Name:VALERIO
Other - Last Name:PUNONGBAYAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1200 WILSHIRE BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1919
Mailing Address - Country:US
Mailing Address - Phone:213-481-1515
Mailing Address - Fax:
Practice Address - Street 1:1200 WILSHIRE BLVD STE 401
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1919
Practice Address - Country:US
Practice Address - Phone:213-481-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013414225200000X
CA307989225100000X
NY049195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA067747417OtherUSCIS