NPIMap

Organization Active NPI

Valley Registered Dietitian Network

  • Oncology Nutrition Registered Dietitian
  • Stockton, CA
National Provider Identifier
1831855311
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology Nutrition Registered DietitianTaxonomy code 133VN1301X
Legal business name
VALLEY REGISTERED DIETITIAN NETWORK
Practice address
1805 N California St Ste 308
Stockton, CA 95204-6032
Phone
(209) 227-0722
Fax
(866) 862-8832
NPI assigned
Nov 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Macie Young
Title
Practice Manager
Phone
(916) 407-6732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Nutrition Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133VN1301X Primary

Addresses

Primary practice location

1805 N California St Ste 308
Stockton, CA 95204-6032

Mailing address

1805 N California St Ste 308
Stockton, CA 95204-6032
Phone (209) 227-0722

Other names 1

  • VRDN Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220105001437 CA Part B Supplier - Clinic/Group Practice 8426449281 Receives reassigned benefits from 7 practitioners
Practice locations: Stockton, CA

National Provider Directory

National Provider Directory

Locations

415 W Benjamin Holt Dr
Stockton, CA 95207
Phone (209) 227-0722

1805 N California St
Ste 308
Stockton, CA 95204
Phone (209) 227-0722

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776988800000",
    "number": "1831855311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST STE 308",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046032",
            "telephone_number": "209-227-0722",
            "fax_number": "866-862-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N CALIFORNIA ST STE 308",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046032",
            "telephone_number": "209-227-0722",
            "fax_number": "866-862-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY REGISTERED DIETITIAN NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-09",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MACIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "916-407-6732"
    },
    "taxonomies": [
        {
            "code": "133VN1301X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VRDN",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "VRDN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.