Provider Demographics
NPI:1851972301
Name:PARILLA, GABRIELLE RENEE (RDN)
Entity Type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:RENEE
Last Name:PARILLA
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79-7140 MAMALAHOA HWY
Mailing Address - Street 2:
Mailing Address - City:HOLUALOA
Mailing Address - State:HI
Mailing Address - Zip Code:96725-9711
Mailing Address - Country:US
Mailing Address - Phone:617-957-3190
Mailing Address - Fax:
Practice Address - Street 1:79-7140 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:HOLUALOA
Practice Address - State:HI
Practice Address - Zip Code:96725-9711
Practice Address - Country:US
Practice Address - Phone:617-957-3190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86109293133V00000X
HI312-LD133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered