Provider Demographics
NPI:1225603178
Name:CRABILL, DANIELA VERAS (MS, RD)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:VERAS
Last Name:CRABILL
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1382 STOCKBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95130-1252
Mailing Address - Country:US
Mailing Address - Phone:408-834-0371
Mailing Address - Fax:
Practice Address - Street 1:1382 STOCKBRIDGE DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95130-1252
Practice Address - Country:US
Practice Address - Phone:408-834-0371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86110087133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered