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General NPI Number Information
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NPI Number | 1659400612
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Entity Type | Individual
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Provider Name | SANDY E CORTEZ RD CFT
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1776 YGNACIO VALLEY RD STE 201
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City | WALNUT CREEK
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State | CA
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Zip | 94598-3125
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Country | US
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Telephone | 925-305-1919
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Fax | 925-407-2838
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Provider Business Mailing Address
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Address Line | 1776 YGNACIO VALLEY RD STE 201
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City | WALNUT CREEK
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State | CA
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Zip | 94598-3125
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Country | US
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Telephone | 925-305-1919
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Fax | 925-407-2838
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 0958881
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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