Individual provider Active NPI

Djair Valdez

  • Driver
  • San Bernardino, CA
National Provider Identifier
1013684315
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
F2014629 Issued in CA
Practice address
699 N Arrowhead Ave Ste 116
San Bernardino, CA 92401-1143
Phone
(951) 902-5595
NPI assigned
Aug 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X F2014629 CA Primary

Addresses

Primary practice location

699 N Arrowhead Ave Ste 116
San Bernardino, CA 92401-1143

Mailing address

15025 Elm CT Apt a
Moreno Valley, CA 92551-3655
Phone (951) 902-5595

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
F2014629CAMDDriver

Practice roles

OrganizationSpecialtyStatusNew patients
JD Medical Transportation LLC CurrentSince Aug 29, 2021 Accepting new patients

Locations

699 N Arrowhead Ave
Ste 116
San Bernardino, CA 92401
Phone (951) 902-5595

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1013684315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15025 ELM CT APT A",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925513655",
            "telephone_number": "951-902-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 N ARROWHEAD AVE STE 116",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011143",
            "telephone_number": "951-902-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "DJAIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "CA",
            "license": "F2014629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.