Provider Demographics
NPI:1831803758
Name:SANTOS, VALERIE MARIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:MARIE
Last Name:SANTOS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9445 FAIRWAY VIEW PL STE 100
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0930
Mailing Address - Country:US
Mailing Address - Phone:909-983-2020
Mailing Address - Fax:909-463-3128
Practice Address - Street 1:9445 FAIRWAY VIEW PL STE 100
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0930
Practice Address - Country:US
Practice Address - Phone:909-983-2020
Practice Address - Fax:909-463-3128
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
373H00000X
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No172V00000XOther Service ProvidersCommunity Health Worker