Provider Demographics
NPI:1760750814
Name:JANES, VICTORIA L (RD, LDN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:JANES
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:L
Other - Last Name:BACHAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32 SOUTH ST
Mailing Address - Street 2:STE 103
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-3555
Mailing Address - Country:US
Mailing Address - Phone:781-788-0088
Mailing Address - Fax:781-736-0111
Practice Address - Street 1:32 SOUTH ST
Practice Address - Street 2:STE 103
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-3555
Practice Address - Country:US
Practice Address - Phone:781-788-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2016-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3224133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic