Provider Demographics
NPI:1831766013
Name:VALENZUELA, SAMANTHA MARII (CPHT)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:MARII
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:MARII
Other - Last Name:LAURENTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 TEMPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-1255
Mailing Address - Country:US
Mailing Address - Phone:415-623-6639
Mailing Address - Fax:
Practice Address - Street 1:550 TEMPLETON AVE
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-1255
Practice Address - Country:US
Practice Address - Phone:415-623-6639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician