Lucy Anne Valencia, D.D.S.
Individual provider Active NPI Dentist · Plymouth, CA
NPI 1174884035 · NPPES record last updated Jun 6, 2012
Key facts
- NPI
- 1174884035
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 52949 (CA)
- Practice address
- 9449 Landrum Street
Plymouth, CA 95660-0670 - Phone
- (209) 245-4413
- NPI assigned
- Jun 6, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52949 | CA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 52949 | CA | Yes |
Addresses
Primary practice location
9449 Landrum Street
Plymouth, CA 95660-0670
Mailing address
PO Box 670
Plymouth, CA 95669-0670
Phone (209) 245-4413
Other providers in Plymouth, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.