Individual provider Active NPI

Vallesky Berrich

  • Physician Assistant
  • Sacramento, CA
National Provider Identifier
1235969908
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033628 Issued in NY
Practice address
1445 Sebastian Way
Sacramento, CA 95864-2736
Phone
(410) 474-2495
NPI assigned
Aug 6, 2024
Last updated
Jul 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 033628 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X NU
Athletic Trainer 2255A2300X NU

Addresses

Primary practice location

1445 Sebastian Way
Sacramento, CA 95864-2736

Mailing address

920 Colton CT
Prince Frederick, MD 20678-4160
Phone (410) 474-2495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20250626000934 NY Practitioner - Physician Assistant 1658883459 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033628NYMDMassage Therapist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1235969908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 COLTON CT",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784160",
            "telephone_number": "410-474-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 SEBASTIAN WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958642736",
            "telephone_number": "410-474-2495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRICH",
        "first_name": "VALLESKY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033628",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.