Individual provider Active NPI

Jetta Valle, MSN, PMHNP, FNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Queen Creek, AZ
National Provider Identifier
1720336910
Registry record updated Aug 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP10652 Issued in AZ
Practice address
21168 E Ocotillo Rd # 1271
Queen Creek, AZ 85142-8175
Phone
(520) 677-8025
Fax
(888) 205-9338
NPI assigned
Aug 21, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X AP10652 AZ
Family Nurse Practitioner 363LF0000X AP10652 AZ
Primary Care Nurse Practitioner 363LP2300X AP10652 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP10652 AZ Primary

Addresses

Primary practice location

21168 E Ocotillo Rd # 1271
Queen Creek, AZ 85142-8175

Mailing address

21168 E Ocotillo Rd # 1271
Queen Creek, AZ 85142-8175
Phone (520) 677-8025

Other practice location 1

21168 E Ocotillo Rd # 1271
Queen Creek, AZ 85142-8175
Phone (606) 571-5117

Other identifiers 1

IdentifierTypeStateIssuer
204924MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161104001850 TX Practitioner - Nurse Practitioner 5991953911 Reassigns benefits to 1 organization
I20180214001235 AZ Practitioner - Nurse Practitioner 5991953911 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Oct 3, 2016 Accepting new patients
Horizon Health and Wellness, Inc. CurrentSince Mar 22, 2022 Accepting new patients
Horizon Health and Wellness, Inc. CurrentSince Mar 22, 2022 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital Current Accepting new patients
Good Health Medical, PLLC Current Accepting new patients
Horizon Health and Wellness, Inc. Current Accepting new patients
Good Health Medical, PLLC CurrentSince Feb 5, 2018 Accepting new patients
Good Health Medical, PLLC CurrentSince Feb 5, 2018 Accepting new patients
Horizon Health and Wellness, Inc. Past Accepting new patients
Horizon Health and Wellness, Inc. Psychiatric/Mental Health Past Accepting new patients

Locations

625 N Plaza Dr
Apache Junction, AZ 85120
Phone (480) 282-6278

115 W 2nd St
Casa Grande, AZ 85122
Phone (520) 836-1688

261 N Roosevelt Ave
Chandler, AZ 85226
Phone (480) 305-2888

495 N Pinal Pkwy
Ste 106
Florence, AZ 85132
Phone (520) 568-0573

450 W Adamsville Rd
Florence, AZ 85132
Phone (520) 296-7169

428 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 632-7400

287 E Hunt Hwy
Ste 105
San Tan Valley, AZ 85143
Phone (480) 667-8282

Organizations & group practices 10

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": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755993600000",
    "number": "1720336910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21168 E OCOTILLO RD # 1271",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851428175",
            "telephone_number": "520-677-8025",
            "fax_number": "888-205-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21168 E OCOTILLO RD # 1271",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851428175",
            "telephone_number": "520-677-8025",
            "fax_number": "888-205-9338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21168 E Ocotillo Rd # 1271",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851428175",
            "country_code": "US",
            "telephone_number": "606-571-5117",
            "fax_number": "888-205-9338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLE",
        "first_name": "JETTA",
        "name_prefix": "Mrs.",
        "credential": "MSN, PMHNP, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-21",
        "last_updated": "2025-08-24",
        "certification_date": "2025-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "AZ",
            "license": "AP10652",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP10652",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "AP10652",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP10652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204924",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.