Provider Demographics
NPI:1366244303
Name:CHAVEZ, JUAN VALENTIN
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:VALENTIN
Last Name:CHAVEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12790 WATSONVILLE RD SPC E
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-9105
Mailing Address - Country:US
Mailing Address - Phone:408-607-9899
Mailing Address - Fax:
Practice Address - Street 1:12790 WATSONVILLE RD SPC E
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-9105
Practice Address - Country:US
Practice Address - Phone:408-607-9899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14902225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist