Provider Demographics
NPI:1770031635
Name:HETHERTON, MARIA CATHERINE (RD, CSP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CATHERINE
Last Name:HETHERTON
Suffix:
Gender:F
Credentials:RD, CSP
Other - Prefix:MISS
Other - First Name:MARIA
Other - Middle Name:CATHERINE
Other - Last Name:MELKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, CSP
Mailing Address - Street 1:1855 4TH ST
Mailing Address - Street 2:BOX 4002
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2350
Mailing Address - Country:US
Mailing Address - Phone:415-502-9835
Mailing Address - Fax:415-514-4359
Practice Address - Street 1:1855 4TH ST
Practice Address - Street 2:BOX 4002
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2350
Practice Address - Country:US
Practice Address - Phone:415-502-9835
Practice Address - Fax:415-514-4359
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric