Provider Demographics
NPI:1447792601
Name:DIPRETE, PETER II (RD, RDN, LD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:DIPRETE
Suffix:II
Gender:M
Credentials:RD, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 GRAPE VINE AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-9547
Mailing Address - Country:US
Mailing Address - Phone:415-827-3576
Mailing Address - Fax:
Practice Address - Street 1:816 GRAPE VINE AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89002-9547
Practice Address - Country:US
Practice Address - Phone:415-827-3576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV86055586133V00000X
NV39022-DI-0133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered