Provider Demographics
NPI:1578275574
Name:MEADOWS, AURORA (RD)
Entity Type:Individual
Prefix:
First Name:AURORA
Middle Name:
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:UNDURRAGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1270 FRANCISCAN CT UNIT 8
Mailing Address - Street 2:
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93013-1258
Mailing Address - Country:US
Mailing Address - Phone:805-637-3177
Mailing Address - Fax:
Practice Address - Street 1:931 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:CARPINTERIA
Practice Address - State:CA
Practice Address - Zip Code:93013-2028
Practice Address - Country:US
Practice Address - Phone:805-560-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1023120133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA15820788Medicaid