Provider Demographics
NPI:1891597191
Name:VALDEZ, BIANCA AVALON
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:AVALON
Last Name:VALDEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18630 CABLE LN
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-8707
Mailing Address - Country:US
Mailing Address - Phone:562-246-4184
Mailing Address - Fax:
Practice Address - Street 1:18630 CABLE LN
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-8707
Practice Address - Country:US
Practice Address - Phone:562-246-5844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator