Provider Demographics
NPI:1811366990
Name:OBERTO, TERRI (CNC CPT PHT)
Entity Type:Individual
Prefix:MRS
First Name:TERRI
Middle Name:
Last Name:OBERTO
Suffix:
Gender:F
Credentials:CNC CPT PHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CURTIS ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-2911
Mailing Address - Country:US
Mailing Address - Phone:831-588-8126
Mailing Address - Fax:
Practice Address - Street 1:120 CURTIS ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-2911
Practice Address - Country:US
Practice Address - Phone:831-588-8126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education