Provider Demographics
NPI:1063047983
Name:VALVERDE, TAMESHA PATRICE (IBCLC)
Entity type:Individual
Prefix:MS
First Name:TAMESHA
Middle Name:PATRICE
Last Name:VALVERDE
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 ADMIRAL DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-1502
Mailing Address - Country:US
Mailing Address - Phone:209-688-5287
Mailing Address - Fax:
Practice Address - Street 1:4662 PRECISSI LN STE 200
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6225
Practice Address - Country:US
Practice Address - Phone:209-751-3908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-11
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
CAL-34739174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula