Provider Demographics
NPI:1194442657
Name:POLMAN, VALENTINA (RN)
Entity type:Individual
Prefix:
First Name:VALENTINA
Middle Name:
Last Name:POLMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 GELLERT BLVD APT 2412
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-5430
Mailing Address - Country:US
Mailing Address - Phone:415-519-7146
Mailing Address - Fax:
Practice Address - Street 1:2250 GELLERT BLVD APT 2412
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5430
Practice Address - Country:US
Practice Address - Phone:415-519-7146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-25
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95023253163WG0000X
CA687169163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1194442657OtherCALIFORNIA BOARD OF NURSING