NPIMap

Organization Active NPI

Valle del Sol, Inc.

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
National Provider Identifier
1255614079
Registry record updated Dec 18, 2025
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
3807 N 7TH St
Phoenix, AZ 85014-5005
Phone
(602) 258-6797
NPI assigned
Sep 28, 2011
Last updated
Dec 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

3807 N 7TH St
Phoenix, AZ 85014-5005

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
O20141125000648 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 1255614079. Details of each certification follow.

Federally qualified health center certification: CCN 031921

Legal name
VALLE DEL SOL INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 29, 2014
Last certification
Oct 29, 2014
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Dec 9, 1970 in AZ
Enrollment address
3807 N 7TH St
Phoenix, AZ 85014-5005

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

1209 S 1st Ave
Phoenix, AZ 85003
Phone (602) 282-8006

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
June Campbell Individual Corporate Director Jan 1, 2021
Andrew Cooper Individual Corporate Director Jan 1, 2021
Margarita Silva Individual Corporate Director Jul 1, 2023
Manuel Calero Individual Corporate Director Jan 1, 2022
Teri Leon Individual Corporate Director Jul 14, 2023
Berta Carbajal Individual Corporate Director May 1, 2022
Sumit Chohan Individual Corporate OfficerCfo Sep 18, 2023
Operational/Managerial Control Sep 18, 2023
Shelli Ross Individual Corporate OfficerCeo Mar 15, 2021
W-2 Managing Employee Mar 15, 2021
Florentino Gabriel Licon Individual Corporate Director Aug 1, 2014
Michael Renaud Individual Corporate OfficerCeo Jul 10, 2023
W-2 Managing Employee Jul 10, 2023
Operational/Managerial Control Jul 10, 2023
Rebecca Razo Individual W-2 Managing EmployeeContracts Director May 7, 2018
Virginia Valenzuela Individual Corporate Director Jan 1, 2023
Diana Ixchel del Castillo Medina Individual Corporate Director Jan 1, 2022
Linda McPhaul Individual Corporate Director Jan 1, 2022
Valle del Sol Inc Organization, Phoenix, AZ Corporation, Non-profit Operational/Managerial Control Sep 4, 2018
Laura Balderrama Individual Corporate Director Jan 1, 2023
Richard Kautz Individual Corporate Director Jan 1, 2023

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 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
Valle del Sol IncPhoenix, AZ, CCN 031063 Federally qualified health center Operational/Managerial Control Aug 5, 2025

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 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766016000000",
    "number": "1255614079",
    "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": "3807 N 7TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850145005",
            "telephone_number": "602-258-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLE DEL SOL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-28",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A",
        "authorized_official_last_name": "RAZO",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CONTRACTS DIRECTOR",
        "authorized_official_telephone_number": "602-258-6797"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.