Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND-372 | CA |
NPI | 1134454416 |
---|---|
Provider Name | Dr. Irene Joy Valencia |
First Address | Santa Cruz, CA 95060-3761 |
Second Address | Santa Cruz, CA 95060-3761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2009 |
Last Update Date | 05/10/2009 |