Individual provider Active NPI

Jesus Abraham Valtierra, FNP STUDENT

  • Student in an Organized Health Care Education/Training Program
  • San Luis, AZ
National Provider Identifier
1013833276
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1471 E Udall LN
San Luis, AZ 85336-0924
Phone
(928) 315-0859
NPI assigned
Jun 24, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AZ Primary

Addresses

Primary practice location

1471 E Udall LN
San Luis, AZ 85336-0924

Mailing address

PO Box 8875
San Luis, AZ 85349-6835
Phone (928) 315-0859

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

NPI Registry JSON

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

{
    "created_epoch": "1782259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1013833276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8875",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "853496835",
            "telephone_number": "928-315-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 E UDALL LN",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "853360924",
            "telephone_number": "928-315-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALTIERRA",
        "first_name": "JESUS",
        "middle_name": "ABRAHAM",
        "credential": "FNP STUDENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-24",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; 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.