Provider Demographics
NPI:1881752533
Name:ASSEMI, VALERIE A (RPT)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:A
Last Name:ASSEMI
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 EXPOSITION DR UNIT 30
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-5547
Mailing Address - Country:US
Mailing Address - Phone:805-461-5514
Mailing Address - Fax:
Practice Address - Street 1:2230 EXPOSITION DR UNIT 30
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-5547
Practice Address - Country:US
Practice Address - Phone:805-461-5514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28173208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGPT001411Medicaid
CAOPT28173OtherBLUE SHIELD
CAZZZZ06333ZOtherBLUE SHIELD GROUP
CAPT28173OtherBLUE CROSS
CAWPT28173CMedicare ID - Type Unspecified