Provider Demographics
NPI:1548809064
Name:VALENCIA, RILEE NICOLE
Entity type:Individual
Prefix:
First Name:RILEE
Middle Name:NICOLE
Last Name:VALENCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RILEE
Other - Middle Name:NICOLE
Other - Last Name:HORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18191 VON KARMAN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-7103
Mailing Address - Country:US
Mailing Address - Phone:619-639-9738
Mailing Address - Fax:619-374-1359
Practice Address - Street 1:18191 VON KARMAN AVE STE 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-7103
Practice Address - Country:US
Practice Address - Phone:619-639-9738
Practice Address - Fax:619-374-1359
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-01
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95201650163W00000X
CA95032894363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse