Individual provider Active NPI

Alyssa Raquel Valdez

  • Psychiatric/Mental Health Nurse Practitioner
  • West Lake Hills, TX
National Provider Identifier
1255046470
Registry record updated Jun 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1112550 Issued in TX
Practice address
4407 Bee Caves Rd. Ste 422
West Lake Hills, TX 78746-5532
Phone
(512) 469-0535
Fax
(512) 387-3515
NPI assigned
Jan 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1112550 TX Primary

Addresses

Primary practice location

4407 Bee Caves Rd. Ste 422
West Lake Hills, TX 78746-5532

Mailing address

4407 Bee Caves Rd. Ste 422
West Lake Hills, TX 78746
Phone (512) 469-0535

Other practice location 1

2115 Arborside Dr
Austin, TX 78754-5532
Phone (361) 652-0239

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

State licenses

LicenseStateTypeSpecialty
1112550TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presence Wellness CurrentSince Jul 2, 2023 Accepting new patients
Ethos Prism, LLC PastSince Jul 2, 2023 Accepting new patients

Locations

4407 Bee Caves Rd
Ste 422
West Lake Hills, TX 78746
Phone (512) 469-0535

Organizations & group practices 2

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": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687651200000",
    "number": "1255046470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4407 BEE CAVES RD. STE 422",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "78746",
            "telephone_number": "512-469-0535",
            "fax_number": "512-387-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 BEE CAVES RD. STE 422",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787465532",
            "telephone_number": "512-469-0535",
            "fax_number": "512-387-3515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2115 Arborside Dr",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787545532",
            "country_code": "US",
            "telephone_number": "361-652-0239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "ALYSSA",
        "middle_name": "RAQUEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-06-25",
        "certification_date": "2023-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1112550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Lake Hills, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2023; 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.