Provider Demographics
NPI:1417684200
Name:FRIAS, MEGAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:
Last Name:FRIAS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 STANISLAUS CT
Mailing Address - Street 2:
Mailing Address - City:SAN BRUNO
Mailing Address - State:CA
Mailing Address - Zip Code:94066-2553
Mailing Address - Country:US
Mailing Address - Phone:650-588-2449
Mailing Address - Fax:
Practice Address - Street 1:140 STANISLAUS CT
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-2553
Practice Address - Country:US
Practice Address - Phone:650-588-2449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist