Provider Demographics
NPI:1639946684
Name:BAJARIAS, BETTY JANE C (RDN)
Entity Type:Individual
Prefix:MS
First Name:BETTY JANE
Middle Name:C
Last Name:BAJARIAS
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 1:8893 W ASBURY AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-2301
Mailing Address - Country:US
Mailing Address - Phone:956-492-5214
Mailing Address - Fax:
Practice Address - Street 1:8893 W ASBURY AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-2301
Practice Address - Country:US
Practice Address - Phone:956-492-5214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO914884133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered