MEDICARE: MELANIE KATHLEEN VALESI FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	NPF95001206	CA

General Provider Information

NPI Number	:	1477920486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE KATHLEEN VALESI FNP

Provider Business Mailing Address
First Line	:	3400 DATA DR
Second Line	:
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95670-7956
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4598 MISSION ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94112-2622
Country	:	US
Telephone Number	:	415-965-7941
Fax Number	:	415-965-7935

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2015
Last Update Date	:	01/30/2017

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