Provider Demographics
NPI:1326660432
Name:DEMARCO, EVAN (RD)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:DEMARCO
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 38TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-6712
Mailing Address - Country:US
Mailing Address - Phone:720-331-1129
Mailing Address - Fax:
Practice Address - Street 1:1524 38TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6712
Practice Address - Country:US
Practice Address - Phone:720-331-1129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist