Provider Demographics
NPI:1972304921
Name:VALENCIA, ENGELBERT GUANLAO
Entity type:Individual
Prefix:
First Name:ENGELBERT
Middle Name:GUANLAO
Last Name:VALENCIA
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 1:6923 TRAPPER CREEK RD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-5660
Mailing Address - Country:US
Mailing Address - Phone:850-291-0547
Mailing Address - Fax:
Practice Address - Street 1:900 LOMA COLORADO BLVD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-6524
Practice Address - Country:US
Practice Address - Phone:505-962-5063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPTA1019225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant