Provider Demographics
NPI:1093091407
Name:CHASE-ESCALANTE, DANIELE ILESA (RD)
Entity Type:Individual
Prefix:
First Name:DANIELE
Middle Name:ILESA
Last Name:CHASE-ESCALANTE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2454 TARTARIAN WAY
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-4332
Mailing Address - Country:US
Mailing Address - Phone:510-303-5199
Mailing Address - Fax:
Practice Address - Street 1:2454 TARTARIAN WAY
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-4332
Practice Address - Country:US
Practice Address - Phone:510-303-5199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-30
Last Update Date:2011-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic