Healthcare Provider Details

I. General information

NPI: 1104840172
Provider Name (Legal Business Name): MELANI VALENTIN APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 LA JOLLA VILLAGE DR MC-125
SAN DIEGO CA
92161-0001
US

IV. Provider business mailing address

3350 LA JOLLA VILLAGE DR MC-125
SAN DIEGO CA
92161-0001
US

V. Phone/Fax

Practice location:
  • Phone: 858-642-3473
  • Fax: 858-534-0104
Mailing address:
  • Phone: 858-642-3473
  • Fax: 858-534-0104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number15407
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number2139
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: