Provider Demographics
NPI:1700484607
Name:SALAZAR, VALERIE CELINA (COA)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:CELINA
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:COA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4760 S WADSWORTH BLVD UNIT G207
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80123-1389
Mailing Address - Country:US
Mailing Address - Phone:303-332-1425
Mailing Address - Fax:
Practice Address - Street 1:4760 S WADSWORTH BLVD UNIT G207
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80123-1389
Practice Address - Country:US
Practice Address - Phone:303-332-1425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO196836156FX1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1101XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
COB752665Medicaid