Provider Demographics
NPI:1760924443
Name:RAMAKRISHNAN, PADMA (MS RD)
Entity Type:Individual
Prefix:
First Name:PADMA
Middle Name:
Last Name:RAMAKRISHNAN
Suffix:
Gender:F
Credentials:MS RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14601 S BASCOM AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2043
Mailing Address - Country:US
Mailing Address - Phone:408-621-2022
Mailing Address - Fax:
Practice Address - Street 1:14601 S BASCOM AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2043
Practice Address - Country:US
Practice Address - Phone:408-621-2022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered