Healthcare Provider Details

I. General information

NPI: 1811815244
Provider Name (Legal Business Name): VITALITY PEPTIDES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 S DEMAREE ST
VISALIA CA
93277-9476
US

IV. Provider business mailing address

4050 S DEMAREE ST
VISALIA CA
93277-9476
US

V. Phone/Fax

Practice location:
  • Phone: 559-240-6065
  • Fax:
Mailing address:
  • Phone: 559-240-6065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MELISSA HOMAN
Title or Position: RN SECRETARY
Credential:
Phone: 559-240-6065