Provider Demographics
NPI:1164031746
Name:ORIHUELA, GUADALUPE (RD)
Entity Type:Individual
Prefix:
First Name:GUADALUPE
Middle Name:
Last Name:ORIHUELA
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 1:3230 HOEN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-7527
Mailing Address - Country:US
Mailing Address - Phone:707-477-4093
Mailing Address - Fax:
Practice Address - Street 1:3230 HOEN AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-7527
Practice Address - Country:US
Practice Address - Phone:707-477-4093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered