Provider Demographics
NPI:1922899194
Name:VALDEZ, RUBEN JR (DPT)
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:VALDEZ
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4228 SAMOSET AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-2821
Mailing Address - Country:US
Mailing Address - Phone:619-201-7283
Mailing Address - Fax:
Practice Address - Street 1:3141 TIGER RUN CT STE 114
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-6706
Practice Address - Country:US
Practice Address - Phone:760-585-2178
Practice Address - Fax:833-409-0654
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT308011225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist