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NPI Code Detail

MEDICARE: MISS ANGELICA GAYATRI SALDIVAR RDN

MEDICARE: MISS ANGELICA GAYATRI SALDIVAR RDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian1016855CA

General Provider Information

NPI Number : 1063929719
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ANGELICA GAYATRI SALDIVAR RDN
Provider Business Mailing Address
First Line : 2423 PROSPECT ST
Second Line :
City : BERKELEY
State : CA
Zip : 94704-2551
Country : US
Telephone Number : 510-725-8216
Fax Number :
Provider Business Practice Location Address
First Line : 2423 PROSPECT ST
Second Line :
City : BERKELEY
State : CA
Zip : 94704-2551
Country : US
Telephone Number : 510-725-8216
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2018
Last Update Date : 01/03/2018

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