Provider Demographics
NPI:1679385728
Name:CAMACHO HERRERA, VALERIA JAZMIN
Entity type:Individual
Prefix:
First Name:VALERIA
Middle Name:JAZMIN
Last Name:CAMACHO HERRERA
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:HC 20 BOX 27805
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:PR
Mailing Address - Zip Code:00754-9697
Mailing Address - Country:US
Mailing Address - Phone:787-482-6496
Mailing Address - Fax:
Practice Address - Street 1:BO. CERRO GORDO/LOS VELAZQUEZ
Practice Address - Street 2:CAR 183 R916 K4 H5
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754
Practice Address - Country:US
Practice Address - Phone:787-482-6496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR166371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical