Healthcare Provider Details

I. General information

NPI: 1407703259
Provider Name (Legal Business Name): VERONICA JUDITH ALCARAZ-REYES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 CLUB DR
VALLEJO CA
94592-1187
US

IV. Provider business mailing address

1310 CLUB DR
VALLEJO CA
94592-1187
US

V. Phone/Fax

Practice location:
  • Phone: 707-638-5565
  • Fax:
Mailing address:
  • Phone: 707-638-5565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: