Provider Demographics
NPI:1437722600
Name:NAVARRO JUNEZ, MARIA FERNANDA (RD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:FERNANDA
Last Name:NAVARRO JUNEZ
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 1:415 W BENJAMIN HOLT DR STE B3
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-3958
Mailing Address - Country:US
Mailing Address - Phone:209-227-0722
Mailing Address - Fax:
Practice Address - Street 1:415 W BENJAMIN HOLT DR STE B3
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-3958
Practice Address - Country:US
Practice Address - Phone:209-762-7047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-23
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86116165133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered