Individual provider Active NPI

Valerieanne Navalta Delacruz, PA-C

  • Physician Assistant
  • Santa Rosa, CA
National Provider Identifier
1467084590
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
68456 Issued in CA
Practice address
220 Concourse Blvd
Santa Rosa, CA 95403-8210
Phone
(844) 527-7369
Fax
(844) 847-4943
NPI assigned
Feb 6, 2020
Reactivated
Jan 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 68456 CA Primary
Medical Physician Assistant 363AM0700X 68456 CA

Addresses

Primary practice location

220 Concourse Blvd
Santa Rosa, CA 95403-8210

Mailing address

220 Concourse Blvd
Santa Rosa, CA 95403-8210
Phone (844) 527-7369

Other practice location 1

5150 Hill Rd E Ste C
Lakeport, CA 95453-5100
Phone (844) 527-7369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260616001273 CA Practitioner - Physician Assistant 6305318858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1384 W Burgundy CT
Hanford, CA 93230-8178

PO Box
Suite 10417
Holyoke, MA 01041

PO Box
Suite 16309
Jacksonville, FL 32245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kadiant, LLC PastSince Feb 1, 2020 Accepting new patients
Central Valley Autism Project, Inc. PastSince Feb 1, 2020 Accepting new patients

Organizations & group practices 3

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": "1580947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1467084590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CONCOURSE BLVD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038210",
            "telephone_number": "844-527-7369",
            "fax_number": "844-847-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 CONCOURSE BLVD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954038210",
            "telephone_number": "844-527-7369",
            "fax_number": "844-847-4943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5150 Hill Rd E Ste C",
            "address_purpose": "LOCATION",
            "city": "Lakeport",
            "state": "CA",
            "postal_code": "954535100",
            "country_code": "US",
            "telephone_number": "844-527-7369",
            "fax_number": "844-847-4943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELACRUZ",
        "first_name": "VALERIEANNE",
        "middle_name": "NAVALTA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-06",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "deactivation_date": "2024-01-16",
        "reactivation_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "68456",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "68456",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.