Provider Demographics
NPI:1790837946
Name:BELLE, SIOTA H (PHD)
Entity Type:Individual
Prefix:DR
First Name:SIOTA
Middle Name:H
Last Name:BELLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7511 BODEGA AVE
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-3655
Mailing Address - Country:US
Mailing Address - Phone:707-829-6895
Mailing Address - Fax:707-829-5572
Practice Address - Street 1:7511 BODEGA AVE
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-3655
Practice Address - Country:US
Practice Address - Phone:707-829-6895
Practice Address - Fax:707-829-5572
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133NN1002X133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic