Provider Demographics
NPI:1033784459
Name:YARNAL GONZALEZ, PATRICIA DAWN (REGISTERED DIETITIAN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:DAWN
Last Name:YARNAL GONZALEZ
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 N ACACIA ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAKE
Mailing Address - State:CA
Mailing Address - Zip Code:93286-1402
Mailing Address - Country:US
Mailing Address - Phone:209-402-9265
Mailing Address - Fax:
Practice Address - Street 1:178 N ACACIA ST
Practice Address - Street 2:
Practice Address - City:WOODLAKE
Practice Address - State:CA
Practice Address - Zip Code:93286-1402
Practice Address - Country:US
Practice Address - Phone:209-402-9265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered