Provider Demographics
NPI:1689112468
Name:PIMENTEL HERNANDEZ, CATHERINE A (MS, RDN, LND)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:A
Last Name:PIMENTEL HERNANDEZ
Suffix:
Gender:F
Credentials:MS, RDN, LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 261869
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-579-1036
Mailing Address - Fax:
Practice Address - Street 1:1629 AVE. PONCE DE LEON
Practice Address - Street 2:URB. CARIBE
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-579-1036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2022133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist