Individual provider Active NPI

Kevin Valdez, FNP

  • Family Nurse Practitioner
  • Santa Ana, CA
National Provider Identifier
1114629649
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95023972 Issued in CA
Practice address
1206 E 17TH St Ste 101
Santa Ana, CA 92701-2641
Phone
(714) 352-2911
Fax
(714) 352-2903
NPI assigned
Mar 20, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95023972 CA Primary

Addresses

Primary practice location

1206 E 17TH St Ste 101
Santa Ana, CA 92701-2641

Mailing address

1206 E 17TH St Ste 101
Santa Ana, CA 92701-2641
Phone (714) 352-2911

Other practice location 1

1401 W 1st St Ste 101
Santa Ana, CA 92703-3757
Phone (714) 542-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240117001272 CA Order and Referring Only - Nurse Practitioner 9537511399

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP95023972CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Urgent Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients
Nogales Medical Clinic, Inc PastSince Mar 1, 2023 Accepting new patients
Serve the People, Inc Past Accepting new patients
Clinica Medica San Lorenzo, Inc. PastSince Apr 20, 2025 Accepting new patients

Locations

1401 W 1st St
Ste 101
Santa Ana, CA 92703
Phone (714) 542-9700

Organizations & group practices 4

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": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1114629649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 E 17TH ST STE 101",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012641",
            "telephone_number": "714-352-2911",
            "fax_number": "714-352-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 E 17TH ST STE 101",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012641",
            "telephone_number": "714-352-2911",
            "fax_number": "714-352-2903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 W 1st St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927033757",
            "country_code": "US",
            "telephone_number": "714-542-9700",
            "fax_number": "714-542-9708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "KEVIN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95023972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.