Provider Demographics
NPI:1437621471
Name:MISTRY, RACHEL ROYA (RD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ROYA
Last Name:MISTRY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16365 ROSELEAF CT
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-3609
Mailing Address - Country:US
Mailing Address - Phone:408-859-2111
Mailing Address - Fax:
Practice Address - Street 1:20398 BLAUER DR
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-4307
Practice Address - Country:US
Practice Address - Phone:408-733-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86148256133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered