Provider Demographics
NPI:1851069785
Name:BASIAGA, MARGARET (RD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:BASIAGA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:BASIAGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:8244 NORTHWIND WAY
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-3737
Mailing Address - Country:US
Mailing Address - Phone:916-517-2146
Mailing Address - Fax:
Practice Address - Street 1:8244 NORTHWIND WAY
Practice Address - Street 2:
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-3737
Practice Address - Country:US
Practice Address - Phone:916-517-2146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1047480133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered