1528214384 NPI number — MS. RITA VALENZUELA LAVELLE MSW

Table of content: MS. RITA VALENZUELA LAVELLE MSW (NPI 1528214384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528214384 NPI number — MS. RITA VALENZUELA LAVELLE MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAVELLE
Provider First Name:
RITA
Provider Middle Name:
VALENZUELA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528214384
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9300 VALLEY CHILDRENS PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MADERA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93636-8761
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-353-3000
Provider Business Mailing Address Fax Number:
559-353-5286

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9300 VALLEY CHILDRENS PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MADERA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93636-8761
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-353-3000
Provider Business Practice Location Address Fax Number:
559-353-5286
Provider Enumeration Date:
08/13/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 08934 . This is a "EMPLOYEE ID" identifier . This identifiers is of the category "OTHER".