Provider Demographics
NPI:1952766834
Name:ORDAZ-VALENZUELA, ELIZABETH (CBE)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ORDAZ-VALENZUELA
Suffix:
Gender:F
Credentials:CBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2024
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85702-2024
Mailing Address - Country:US
Mailing Address - Phone:520-982-7008
Mailing Address - Fax:
Practice Address - Street 1:637 S. 6TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-2024
Practice Address - Country:US
Practice Address - Phone:520-982-7008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ00017509174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator