Provider Demographics
NPI:1508820747
Name:VALDEZ, KRISTI JOY (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:JOY
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:JOY
Other - Last Name:PAULAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, CD
Mailing Address - Street 1:8312 CREEKWOOD AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-6521
Mailing Address - Country:US
Mailing Address - Phone:505-440-7306
Mailing Address - Fax:
Practice Address - Street 1:8312 CREEKWOOD AVE NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-6521
Practice Address - Country:US
Practice Address - Phone:505-440-7306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLD-0624133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
8856854Medicare UPIN