Provider Demographics
NPI:1316448327
Name:VALERO, BERNARDO JESUS JR (ND)
Entity type:Individual
Prefix:MR
First Name:BERNARDO
Middle Name:JESUS
Last Name:VALERO
Suffix:JR
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2840 PARK AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SOQUEL
Mailing Address - State:CA
Mailing Address - Zip Code:95073-2866
Mailing Address - Country:US
Mailing Address - Phone:831-515-8699
Mailing Address - Fax:831-480-7896
Practice Address - Street 1:2840 PARK AVE STE A
Practice Address - Street 2:
Practice Address - City:SOQUEL
Practice Address - State:CA
Practice Address - Zip Code:95073-2866
Practice Address - Country:US
Practice Address - Phone:831-515-8699
Practice Address - Fax:831-480-7896
Is Sole Proprietor?:No
Enumeration Date:2018-02-24
Last Update Date:2018-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA975175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath