Provider Demographics
NPI:1174877500
Name:BARNES-VALDES, KELLEY RENEE (ND)
Entity type:Individual
Prefix:DR
First Name:KELLEY
Middle Name:RENEE
Last Name:BARNES-VALDES
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6119 OLD REDWOOD HWY STE F
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-1124
Mailing Address - Country:US
Mailing Address - Phone:707-244-4800
Mailing Address - Fax:707-244-4200
Practice Address - Street 1:6119 OLD REDWOOD HWY STE F
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-1124
Practice Address - Country:US
Practice Address - Phone:707-244-4800
Practice Address - Fax:707-244-4200
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-07
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND643175F00000X
WANT60314907175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath