Provider Demographics
NPI:1871373696
Name:VALDEZ-ALBERTSON, JULIA AMANDA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:AMANDA
Last Name:VALDEZ-ALBERTSON
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 1:2290 MCDANIEL ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-6330
Mailing Address - Country:US
Mailing Address - Phone:702-899-1924
Mailing Address - Fax:
Practice Address - Street 1:2290 MCDANIEL ST STE 1B
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-6330
Practice Address - Country:US
Practice Address - Phone:702-899-1924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist