Healthcare Provider Details

I. General information

NPI: 1578467213
Provider Name (Legal Business Name): MARIA DEL REFUGIO CISNEROS MS, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA DEL REFUGIO SANCHEZ LEYVA

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N LEWIS ST BLDG 1
ORANGE CA
92868-1538
US

IV. Provider business mailing address

6227 E CARITA ST
LONG BEACH CA
90808-2807
US

V. Phone/Fax

Practice location:
  • Phone: 833-574-2273
  • Fax:
Mailing address:
  • Phone: 310-984-9873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: