Provider Demographics
NPI:1598548133
Name:LEAL, YOLANDA NATALIE (RDN)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:NATALIE
Last Name:LEAL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 W PONTIAC WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93705-2334
Mailing Address - Country:US
Mailing Address - Phone:559-455-3740
Mailing Address - Fax:
Practice Address - Street 1:1926 W PONTIAC WAY
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705-2334
Practice Address - Country:US
Practice Address - Phone:559-455-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered