Individual provider Active NPI

Angelica Faye Valenzuela, PT

  • Physical Therapist
  • Daly City, CA
National Provider Identifier
1376621946
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT30348 Issued in CA
Practice address
455 Hickey Blvd
Ste. 205
Daly City, CA 94015-2629
Phone
(650) 746-3299
Fax
(650) 994-1359
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT30348 CA Primary

Addresses

Primary practice location

455 Hickey Blvd
Ste. 205
Daly City, CA 94015-2629

Mailing address

455 Hickey Blvd
Ste. 205
Daly City, CA 94015-2629
Phone (650) 746-3299

Other practice location 1

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060105000285 CA Practitioner - Physical Therapist in Private Practice 5597788513 Reassigns benefits to 3 organizations
I20251031001825 WA Practitioner - Physical Therapist in Private Practice 5597788513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kitsap Physical Therapy and Sports Clinic PS IncGroup PAC ID 6507762333, 142 clinicians

Practice addresses (Care Compare)

26001 Barber Cut Off Rd
Suite 1
Kingston, WA 98346-9401
Phone (360) 297-7050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30348CAMDMental Health Counselor
PT30348CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Mar 28, 2019 Accepting new patients
Outback Physiotherapy Centre, Inc. Physical Therapist CurrentSince May 6, 2019 Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Aug 18, 2025 Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Physical Therapist CurrentSince Aug 18, 2025 Accepting new patients
On the Move Rehab Physical Therapist CurrentSince Jan 20, 2023 Accepting new patients
West Coast Spine Restoration Center, Inc Physical Therapist PastSince Mar 1, 2003 Accepting new patients

Locations

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

2015 W Park Ave
Ste 16
Redlands, CA 92373
Phone (909) 307-9121

26001 Barber Cut Off Rd NE
Ste C1
Kingston, WA 98346
Phone (360) 297-7050

2400 NW Myhre Rd
Ste 102
Silverdale, WA 98383
Phone (360) 598-3764

2400 NW Myhre Rd
Ste 101
Silverdale, WA 98383
Phone (360) 598-3764

Organizations & group practices 6

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1376621946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 HICKEY BLVD",
            "address_2": "STE. 205",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152629",
            "telephone_number": "650-746-3299",
            "fax_number": "650-994-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 HICKEY BLVD",
            "address_2": "STE. 205",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152629",
            "telephone_number": "650-746-3299",
            "fax_number": "650-994-1359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "ANGELICA FAYE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT30348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.