MEDICARE: MRS. PAULA RAE HERRERA

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	133NN1002X	Nutrition Education Nutritionist		CA

General Provider Information

NPI Number	:	1730018672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAULA RAE HERRERA

Provider Business Mailing Address
First Line	:	1108 E CLARK AVE STE 114
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93455-5177
Country	:	US
Telephone Number	:	323-240-6155
Fax Number	:

Provider Business Practice Location Address
First Line	:	1108 E CLARK AVE STE 114
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93455-5177
Country	:	US
Telephone Number	:	323-240-6155
Fax Number	:

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

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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