Provider Demographics
NPI:1174854533
Name:SUGIUCHI, DIANA KATE (RD/LDN, CNSD)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:KATE
Last Name:SUGIUCHI
Suffix:
Gender:F
Credentials:RD/LDN, CNSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 VIA SUMMA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-8071
Mailing Address - Country:US
Mailing Address - Phone:410-370-0415
Mailing Address - Fax:
Practice Address - Street 1:8415 BELLONA LN STE 213
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2066
Practice Address - Country:US
Practice Address - Phone:410-370-0415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX2754133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered