Provider Demographics
NPI:1568354306
Name:VALENCIA HERNANDEZ, ELIANA
Entity type:Individual
Prefix:
First Name:ELIANA
Middle Name:
Last Name:VALENCIA HERNANDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4740 N GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-2005
Mailing Address - Country:US
Mailing Address - Phone:626-859-2089
Mailing Address - Fax:626-331-3190
Practice Address - Street 1:1211 CENTER COURT DR
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-3627
Practice Address - Country:US
Practice Address - Phone:626-859-2089
Practice Address - Fax:626-331-3190
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner