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Susan Oxendine Valentine

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

10833 Le Conte Ave, Rm 62-182, Los Angeles, CA 90095-1741

PECOS Enrollment

This provider is enrolled in PECOS as SUSAN VALENTINE.

Based on the most recent information from CMS, provider Susan Oxendine Valentine is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 11:47 AM.

Profile Details

Provider ID
1205160025
Provider Type
Individual
Full Name
Valentine, Susan Oxendine
Credential
NP

Gender
Female
Sole Proprietor
No
Enumeration Date
9/25/2009
Last Updated
7/12/2010

Contact Information

Practice Location

10833 Le Conte Ave, Rm 62-182, Los Angeles, CA 90095-1741

(310) 825-9820

Unlisted Fax

Mailing Location

5767 W Century Blvd, Suite 400, Los Angeles, CA 90045-5631

(310) 825-9820

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License NP19235 California

Susan Oxendine Valentine

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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