Provider Demographics
NPI:1609310341
Name:GARCIA, DANNA (RDN)
Entity Type:Individual
Prefix:
First Name:DANNA
Middle Name:
Last Name:GARCIA
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 1:1300 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85034-4598
Mailing Address - Country:US
Mailing Address - Phone:602-257-4323
Mailing Address - Fax:
Practice Address - Street 1:1300 S 10TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-4598
Practice Address - Country:US
Practice Address - Phone:602-257-4323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1034647133V00000X
AZ1034647133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered