Provider Demographics
NPI:1376237057
Name:VALLIN, MARGARITA (REGISTERED DIETITIAN)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:VALLIN
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4438 E NEVADA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-2350
Mailing Address - Country:US
Mailing Address - Phone:559-785-8984
Mailing Address - Fax:
Practice Address - Street 1:4438 E NEVADA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-2350
Practice Address - Country:US
Practice Address - Phone:559-785-8984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86147157133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered