Provider Demographics
NPI:1518035237
Name:MOSLEY, VALENCIA L (MD)
Entity type:Individual
Prefix:DR
First Name:VALENCIA
Middle Name:L
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VALENCIA
Other - Middle Name:L
Other - Last Name:STEPHENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9305 W THOMAS RD
Mailing Address - Street 2:SUITE 155
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-3328
Mailing Address - Country:US
Mailing Address - Phone:623-936-1780
Mailing Address - Fax:623-936-9121
Practice Address - Street 1:9305 W THOMAS RD
Practice Address - Street 2:SUITE 155
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3328
Practice Address - Country:US
Practice Address - Phone:623-936-1780
Practice Address - Fax:623-936-9121
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36329207V00000X
MI4301065334207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ166424Medicaid
AZ36329OtherLICENSE #
BM6319114OtherDEA
AZ166424Medicaid