Provider Demographics
NPI:1639816507
Name:DELGADILLO, DIANA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:DELGADILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2519 S H ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93304-5605
Mailing Address - Country:US
Mailing Address - Phone:661-837-8405
Mailing Address - Fax:661-837-0408
Practice Address - Street 1:2519 S H ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93304-5605
Practice Address - Country:US
Practice Address - Phone:661-837-8405
Practice Address - Fax:661-837-0408
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered