Individual
DR. MICHELLE F VENEZIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
655 REDWOOD HWY FRONTAGE RD, SUITE 160, MILL VALLEY, CA 94941-3034
(415) 259-9026
(415) 457-4837
Mailing address
2100 4TH ST STE 227, SAN RAFAEL, CA 94901-2699
(415) 259-9026
(415) 457-4837
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
172M00000X
Mechanotherapist
—
—
174400000X
Specialist
—
—
174H00000X
Health Educator
—
—
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
20A8595
CA
207Q00000X
Family Medicine Physician
20A8595
CA
208D00000X
General Practice Physician
20A8595
CA
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
445248
—
CA
Enumeration date
11/07/2006
Last updated
12/26/2014
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