Most Relevant Information
Provider Data
| NPI Number: | 1003308313 |
| Provider Name: | SHAYANE VALENZUELA SANTIAGO ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/01/2018 |
| Last Updated: | 03/09/2022 |
Provider Practice Location
846/848 GRAVENSTEIN HWY S.
SEBASTOPOL
CA
95472
Practice Location Phone/Fax
| Phone: | 3234037476 |
| Fax: |
Provider Mailing Location
846 GRAVENSTEIN HIGHWAY SOUTH
SEBASTOPOL
CA
95472
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |