Provider Demographics
NPI:1346558970
Name:ZAMARRIPA, TABITHA NICHOLE (REGISTERED DIETITIAN)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:NICHOLE
Last Name:ZAMARRIPA
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 S KING ST STE 1555
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2073
Mailing Address - Country:US
Mailing Address - Phone:808-593-1515
Mailing Address - Fax:808-589-5993
Practice Address - Street 1:1314 S KING ST STE 1555
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2073
Practice Address - Country:US
Practice Address - Phone:808-593-1515
Practice Address - Fax:808-589-5993
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1015131133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1015131OtherREGISTERED DIETICIAN
HI89-LDOtherDIETITIAN LICENSE