Provider Demographics
NPI:1609562990
Name:COOK, ALEXANDRA (RD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9256 REGENTS RD APT C
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1426
Mailing Address - Country:US
Mailing Address - Phone:440-667-7840
Mailing Address - Fax:
Practice Address - Street 1:9256 REGENTS RD APT C
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1426
Practice Address - Country:US
Practice Address - Phone:440-667-7840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered