Tavis Valenzuela, PA-S is a
Student In An Organized Health Care Education/training Program based in Camarillo, California. Tavis Valenzuela is licensed to practice in California (license number ) and his current practice location is
2748 Via Corza, Camarillo, California. He can be reached at his office (for appointments etc.) via phone at
(805) 312-4700.
NPI number for Tavis Valenzuela is 1356158422 and his current mailing address is 2748 Via Corza, Camarillo, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1356158422.
Provider's Profile
| Full Name | Tavis Valenzuela |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 2748 Via Corza, Camarillo, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1356158422
- Provider Enumeration Date: 12/12/2024
- Last Update Date: 12/12/2024
Medical Identifiers
Medical identifiers for Tavis Valenzuela such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356158422 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tavis Valenzuela is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tavis Valenzuela, PA-S
2748 Via Corza,
Camarillo, CA 93010-2233
Ph: (805) 312-4700 | Tavis Valenzuela, PA-S
2748 Via Corza,
Camarillo, CA 93010-2233
Ph: (805) 312-4700 |
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