Provider Demographics
NPI:1043199920
Name:VENZOR, FAITH
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:VENZOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-3011
Mailing Address - Country:US
Mailing Address - Phone:626-633-2956
Mailing Address - Fax:
Practice Address - Street 1:500 N LORAINE AVE
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-2964
Practice Address - Country:US
Practice Address - Phone:626-963-1611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty