Healthcare Provider Details

I. General information

NPI: 1952080400
Provider Name (Legal Business Name): MARIA FERNANDA ESPINOSA NUNES RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FERNANDA NUNES RD

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1921 SAN PABLO AVE
OAKLAND CA
94612-1305
US

IV. Provider business mailing address

1921 SAN PABLO AVE
OAKLAND CA
94612-1305
US

V. Phone/Fax

Practice location:
  • Phone: 832-600-7430
  • Fax:
Mailing address:
  • Phone: 832-600-7430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86147118
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: