Healthcare Provider Details

I. General information

NPI: 1497670194
Provider Name (Legal Business Name): VAENIN VALIANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27300 IRIS AVE
MERENO VALLEY CA
92555
US

IV. Provider business mailing address

7814 CAROUSEL LN SUITE 210
RICHMOND VA
23294
US

V. Phone/Fax

Practice location:
  • Phone: 360-951-3803
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDI61307885
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: