Provider Demographics
NPI:1073199832
Name:FRAUSTO, JOANNA MARGARITA (NUTRITIONIST/ HEALTH)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:MARGARITA
Last Name:FRAUSTO
Suffix:
Gender:F
Credentials:NUTRITIONIST/ HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92113-2113
Mailing Address - Country:US
Mailing Address - Phone:619-515-2526
Mailing Address - Fax:619-234-8884
Practice Address - Street 1:1809 NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-2113
Practice Address - Country:US
Practice Address - Phone:619-515-2526
Practice Address - Fax:619-234-8884
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator