Provider Demographics
NPI:1568665677
Name:PARKER, DOROTHY CARR (RD)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:CARR
Last Name:PARKER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:FAY
Other - Last Name:CARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 BRYSON AVE
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-2503
Mailing Address - Country:US
Mailing Address - Phone:650-327-8274
Mailing Address - Fax:
Practice Address - Street 1:750 S BASCOM AVE
Practice Address - Street 2:DIABETES ED
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2603
Practice Address - Country:US
Practice Address - Phone:408-885-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACRD819533133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered