| NPI | 1003100363 | 
|---|---|
| Former Name | JESSICA VALENZUELA | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP120603)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 708869)  | 
| Enumeration Date | 2011-06-04 | 
| Last Update Date | 2021-12-10 |