Provider Demographics
NPI:1508530031
Name:PELLETT, MARTA (RD)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:PELLETT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:MARTA
Other - Middle Name:
Other - Last Name:TABATABAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:355 ABBOTT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4483
Mailing Address - Country:US
Mailing Address - Phone:831-422-3636
Mailing Address - Fax:
Practice Address - Street 1:355 ABBOTT ST STE 200
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4483
Practice Address - Country:US
Practice Address - Phone:831-422-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-07
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86242466133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered