Provider Demographics
NPI:1548331069
Name:DAHLBERG, PATRICIA VALBUENA (RN, PNP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:VALBUENA
Last Name:DAHLBERG
Suffix:
Gender:F
Credentials:RN, PNP
Other - Prefix:MISS
Other - First Name:CLAUDIA
Other - Middle Name:PATRICIA
Other - Last Name:VALBUENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, PNP
Mailing Address - Street 1:2265 ESTRIBO DR
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-5111
Mailing Address - Country:US
Mailing Address - Phone:310-548-0205
Mailing Address - Fax:
Practice Address - Street 1:1300 W 7TH ST
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90732-3505
Practice Address - Country:US
Practice Address - Phone:310-514-5465
Practice Address - Fax:310-514-5478
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN#221764363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics