Provider Demographics
NPI:1467773358
Name:PORSONA, NEHEMIAH VILLARIAS (RD)
Entity Type:Individual
Prefix:MR
First Name:NEHEMIAH
Middle Name:VILLARIAS
Last Name:PORSONA
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 RAYNOR ST
Mailing Address - Street 2:
Mailing Address - City:COLTON
Mailing Address - State:CA
Mailing Address - Zip Code:92324-7520
Mailing Address - Country:US
Mailing Address - Phone:951-961-1979
Mailing Address - Fax:909-514-0462
Practice Address - Street 1:1029 RAYNOR ST
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-7520
Practice Address - Country:US
Practice Address - Phone:951-961-1979
Practice Address - Fax:909-514-0462
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA814377133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered