Provider Demographics
NPI:1356227151
Name:VALENCIA, SHELLEY LEANN (LPTA)
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:LEANN
Last Name:VALENCIA
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ZINFANDEL RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-7727
Mailing Address - Country:US
Mailing Address - Phone:504-377-5699
Mailing Address - Fax:
Practice Address - Street 1:100 ZINFANDEL RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-7727
Practice Address - Country:US
Practice Address - Phone:504-377-5699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306606798225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty