Provider Demographics
NPI:1558317610
Name:LOPEZ, JULIA (NUTRITIONIST)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6013
Mailing Address - Country:US
Mailing Address - Phone:559-791-7049
Mailing Address - Fax:559-734-1247
Practice Address - Street 1:12586 AVENUE 408
Practice Address - Street 2:
Practice Address - City:OROSI
Practice Address - State:CA
Practice Address - Zip Code:93647-9454
Practice Address - Country:US
Practice Address - Phone:559-528-2804
Practice Address - Fax:559-528-7623
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist