Healthcare Provider Details

I. General information

NPI: 1467370908
Provider Name (Legal Business Name): VELEDA A DOUGLAS RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 W EL NORTE PKWY APT D4
ESCONDIDO CA
92026-3372
US

IV. Provider business mailing address

1820 W EL NORTE PKWY APT D4
ESCONDIDO CA
92026-3372
US

V. Phone/Fax

Practice location:
  • Phone: 760-807-1744
  • Fax:
Mailing address:
  • Phone: 760-807-1744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number713042
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: