Provider Demographics
NPI:1629115233
Name:HWANG, VIRGINIA Y (RD, CDE)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:Y
Last Name:HWANG
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:Y
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD CDE
Mailing Address - Street 1:7788 DUBLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2923
Mailing Address - Country:US
Mailing Address - Phone:510-331-8818
Mailing Address - Fax:
Practice Address - Street 1:5725 W LAS POSITAS BLVD STE 220
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4166
Practice Address - Country:US
Practice Address - Phone:925-416-6715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA808543133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered