Provider Demographics
NPI:1174802581
Name:VALENZUELA, JOVITA LAYON (LVN, LPN)
Entity type:Individual
Prefix:MRS
First Name:JOVITA
Middle Name:LAYON
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:LVN, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USAG JAPAN UNIT 45013 BOX 2415
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96338-5013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:USAG JAPAN UNIT 45013 BOX 2415
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96338-5013
Practice Address - Country:US
Practice Address - Phone:315-263-4128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5155866164W00000X
CAVN147139164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA147139OtherLICENSED VOCATIONAL NURSE
FLPN5155866OtherLICENSED PRACTICAL NURSE