NPIMap

Organization Active NPI

Valle del Sol, Inc.

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
National Provider Identifier
1174345839
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VALLE DEL SOL, INC.
Practice address
4344 W Indian School Rd Ste 16
Phoenix, AZ 85031-2985
Phone
(602) 258-6797
NPI assigned
Oct 24, 2024
Last updated
Oct 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Authorized official

Name
Rebecca Razo
Title
Director of Contracts & Licensing
Phone
(602) 258-6797

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

4344 W Indian School Rd Ste 16
Phoenix, AZ 85031-2985

Mailing address

3877 N 7TH St Ste 400
Phoenix, AZ 85014-5061
Phone (602) 258-6797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050516000299 AZ Part B Supplier - Clinic/Group Practice 8628019148 Receives reassigned benefits from 76 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Mesa, AZ
O20251003001451 AZ Part A Provider - Federally Qualified Health Center (FQHC) 8628019148 Practice locations: Phoenix, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174345839. Details of each certification follow.

Federally qualified health center certification: CCN 031063

Legal name
VALLE DEL SOL INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 25, 2025
Last certification
Aug 25, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
4344 W Indian School Rd
Ste 16
Phoenix, AZ 85031-2985

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Valle del Sol Incorporated17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

10320 W McDowell Rd
Bldg D
Avondale, AZ 85392

10320 W McDowell Rd
Ste D
Avondale, AZ 85392

4135 S Power Rd
Ste 108
Mesa, AZ 85212
Phone (480) 641-1511

1021 S 7th Ave
Phoenix, AZ 85007
Phone (602) 229-5000

1510 S 19th Dr
#100
Phoenix, AZ 85009

511 S Rockford Dr
Tempe, AZ 85288
Phone (602) 523-9312

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Andrew Cooper Individual Corporate Officer Jan 1, 2025
Ramon Martinez Individual Corporate Director Oct 10, 2025
Margarita Silva Individual Corporate Officer Jan 1, 2025
Teri Leon Individual Corporate Officer Jan 1, 2025
Rene Rosales Individual Corporate Director Jan 1, 2025
Sumit Chohan Individual Corporate OfficerCfo Sep 18, 2023
Florentino Gabriel Licon Individual Corporate Director Nov 1, 2019
Cesareo Deanda Individual Corporate Director Jan 1, 2025
Michael Renaud Individual Corporate Officer Jul 10, 2023
W-2 Managing EmployeeCeo Jul 10, 2023
Rebecca Razo Individual W-2 Managing Employee May 7, 2018
Diego Espinoza Individual Corporate Director Jan 1, 2025
Iczel Bojorquez Individual Corporate Director Jan 1, 2025
Linda McPhaul Individual Corporate Director Nov 1, 2019
Valle del Sol Inc Organization, Phoenix, AZ Corporation, Non-profit Operational/Managerial Control Aug 5, 2025
Dusty Curry Individual Corporate Director Jan 1, 2025
Laura Balderrama Individual Corporate Director Jan 1, 2025

Owners & managing parties with NPI records 9

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Valle del Sol IncPhoenix, AZ, CCN 031921 Federally qualified health center Operational/Managerial Control Sep 4, 2018
Valle del Sol IncPhoenix, AZ, CCN 031922 Federally qualified health center Operational/Managerial Control Feb 16, 2015
Valle del Sol IncPhoenix, AZ, CCN 031954 Federally qualified health center Other Jul 24, 2017
Valle del Sol IncMesa, AZ, CCN 031972 Federally qualified health center Other May 1, 2018
Valle del Sol IncPhoenix, AZ, CCN 031986 Federally qualified health center Operational/Managerial Control Nov 1, 2019
Valle del Sol IncMesa, AZ, CCN 031006 Federally qualified health center Operational/Managerial Control Dec 9, 1970

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1174345839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3877 N 7TH ST STE 400",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145061",
            "telephone_number": "602-258-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4344 W INDIAN SCHOOL RD STE 16",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850312985",
            "telephone_number": "602-258-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLE DEL SOL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "RAZO",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTS & LICENSING",
        "authorized_official_telephone_number": "602-258-6797"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.