Provider Demographics
NPI:1225770951
Name:VAZQUEZ, MELISSA (MPH, RDN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6218 SUNNYHILLS PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-7778
Mailing Address - Country:US
Mailing Address - Phone:909-702-4226
Mailing Address - Fax:
Practice Address - Street 1:6218 SUNNYHILLS PL
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91737-7778
Practice Address - Country:US
Practice Address - Phone:909-702-4226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered