Provider Demographics
NPI:1730071234
Name:GARCIA VALDIVIESO, JENNY M (MD)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:M
Last Name:GARCIA VALDIVIESO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4141 NORSE WAY STE A
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1568
Mailing Address - Country:US
Mailing Address - Phone:562-986-8761
Mailing Address - Fax:
Practice Address - Street 1:4141 NORSE WAY STE A
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1568
Practice Address - Country:US
Practice Address - Phone:562-986-8761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist