Provider Demographics
NPI:1922309368
Name:GALARZA PACHECO, YANIRA (LND,MPH)
Entity Type:Individual
Prefix:
First Name:YANIRA
Middle Name:
Last Name:GALARZA PACHECO
Suffix:
Gender:F
Credentials:LND,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 DALIAS STREET
Mailing Address - Street 2:URBANIZACION LOS PINOS
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-0000
Mailing Address - Country:US
Mailing Address - Phone:787-981-0949
Mailing Address - Fax:
Practice Address - Street 1:143 CALLE 25 DE JULIO
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-0069
Practice Address - Country:US
Practice Address - Phone:787-900-2082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-16
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1583133V00000X, 133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR038979001Medicaid