Provider Demographics
NPI:1447024245
Name:VALENZUELA, JESSICA JAZMIN
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:JAZMIN
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7914 RAY BON DR APT 706
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-2151
Mailing Address - Country:US
Mailing Address - Phone:858-218-5423
Mailing Address - Fax:
Practice Address - Street 1:355 SPENCER LN STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-2019
Practice Address - Country:US
Practice Address - Phone:210-346-8715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician