Individual
MRS. TARA VALENZUELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
2309 NORIEGA ST STE 888, SAN FRANCISCO, CA 94122-4239
(843) 474-5578
(843) 790-1871
Mailing address
7901 4TH ST N STE 300, ST PETERSBURG, FL 33702-4399
(843) 474-5578
(843) 790-1871
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
RN95093148
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
165467
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
202101780NP-PP
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95014026
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
APRN-3032
HI
Other
Enumeration date
02/22/2020
Last updated
08/15/2024
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