MEDICARE: SYDNEY VICTORIA NAVARRO

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
1	133V00000X	Registered Dietitian	86170351

General Provider Information

NPI Number	:	1316752371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY VICTORIA NAVARRO

Provider Business Mailing Address
First Line	:	7742 IVANHOE AVE
Second Line	:
City	:	LA JOLLA
State	:	CA
Zip	:	92037-4520
Country	:	US
Telephone Number	:	201-625-3743
Fax Number	:

Provider Business Practice Location Address
First Line	:	5230 FIORE TER APT K101
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-5615
Country	:	US
Telephone Number	:	201-625-3743
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2025
Last Update Date	:	02/07/2025

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