MEDICARE: SOPHIA RENEE AGREDA MS, RDN

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	133V00000X	Registered Dietitian	86432937

General Provider Information

NPI Number	:	1558219436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIA RENEE AGREDA MS, RDN

Provider Business Mailing Address
First Line	:	813 N HUMBOLDT ST
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94401-1468
Country	:	US
Telephone Number	:	650-703-4597
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 CREST DR
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-1606
Country	:	US
Telephone Number	:	559-451-0460
Fax Number	:

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

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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