Provider Demographics
NPI:1942096532
Name:VALENCIA, KRYSTAL J (RC)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:J
Last Name:VALENCIA
Suffix:
Gender:F
Credentials:RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4021 GOODELL LN APT 8
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5059
Mailing Address - Country:US
Mailing Address - Phone:970-413-4712
Mailing Address - Fax:
Practice Address - Street 1:4021 GOODELL LN APT 8
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5059
Practice Address - Country:US
Practice Address - Phone:970-413-4712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO251S00000X, 251B00000X
390200000X, 171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No251S00000XAgenciesCommunity/Behavioral Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No251B00000XAgenciesCase Management