Provider Demographics
NPI:1790006153
Name:ESPINOZA, GAYLA SUZANNE (RD)
Entity Type:Individual
Prefix:MRS
First Name:GAYLA
Middle Name:SUZANNE
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7964 PASEO DEL OCASO
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-3330
Mailing Address - Country:US
Mailing Address - Phone:858-401-0809
Mailing Address - Fax:858-459-5414
Practice Address - Street 1:7964 PASEO DEL OCASO
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-3330
Practice Address - Country:US
Practice Address - Phone:858-401-0809
Practice Address - Fax:858-459-5414
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1027807133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered