Healthcare Provider Details

I. General information

NPI: 1598487076
Provider Name (Legal Business Name): MARLENA BARRI CASTRO MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 09/13/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 S AVENUE A NUTRITION DEPARTMENT
YUMA AZ
85364
US

IV. Provider business mailing address

1137 FLEMMING ST APT A
YUMA AZ
85365-6432
US

V. Phone/Fax

Practice location:
  • Phone: 928-924-3859
  • Fax:
Mailing address:
  • Phone: 504-275-7590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: