Provider Demographics
NPI:1922299155
Name:BIANCO-SIMERAL, STEPHANIE (MS, RD)
Entity Type:Individual
Prefix:PROF
First Name:STEPHANIE
Middle Name:
Last Name:BIANCO-SIMERAL
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:BIANCO
Other - Last Name:SIMERAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, RD
Mailing Address - Street 1:HOLT 106, DEPARTMENT OF NUTRITION AND FOOD SCIENCES
Mailing Address - Street 2:CALIFORNIA STATE UNIVERSITY, CHICO
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95929-0002
Mailing Address - Country:US
Mailing Address - Phone:530-898-4759
Mailing Address - Fax:530-898-5586
Practice Address - Street 1:HOLT 106, DEPARTMENT OF NUTRITION AND FOOD SCIENCES
Practice Address - Street 2:CALIFORNIA STATE UNIVERSITY, CHICO
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95929-0001
Practice Address - Country:US
Practice Address - Phone:530-898-4759
Practice Address - Fax:530-898-5586
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered