Healthcare Provider Details

I. General information

NPI: 1760824585
Provider Name (Legal Business Name): SALONI DESAI R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

687 MONTARA TER
SUNNYVALE CA
94085-3863
US

IV. Provider business mailing address

687 MONTARA TER
SUNNYVALE CA
94085-3863
US

V. Phone/Fax

Practice location:
  • Phone: 202-701-6252
  • Fax:
Mailing address:
  • Phone: 202-701-6252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1029722
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: