Provider Demographics
NPI:1801071139
Name:VALENZUELA, EMILY KAY (LAC)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:KAY
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:418 N EL CAMINO REAL
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-4729
Mailing Address - Country:US
Mailing Address - Phone:949-310-4044
Mailing Address - Fax:
Practice Address - Street 1:31897 DEL OBISPO ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3207
Practice Address - Country:US
Practice Address - Phone:949-310-4044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-06
Last Update Date:2008-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11883171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist