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NPI Code Detail

MEDICARE: DEBRA S D'ANGELO RD, CDE

MEDICARE: DEBRA S D'ANGELO RD, CDE
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 Dietitian164-004070IL
2133V00000XRegistered Dietitian840943CA

General Provider Information

NPI Number : 1841255874
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBRA S D'ANGELO RD, CDE
Provider Business Mailing Address
First Line : 235 S PALISADE DR
Second Line :
City : SANTA MARIA
State : CA
Zip : 93454-5948
Country : US
Telephone Number : 805-739-3561
Fax Number : 805-739-3560
Provider Business Practice Location Address
First Line : 235 S PALISADE DR
Second Line :
City : SANTA MARIA
State : CA
Zip : 93454-5948
Country : US
Telephone Number : 805-739-3561
Fax Number : 805-739-3560
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 10/12/2022

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