Provider Demographics
NPI:1245560754
Name:CHAPA, DOROTHEA OLGA (RD,CDE)
Entity type:Individual
Prefix:MRS
First Name:DOROTHEA
Middle Name:OLGA
Last Name:CHAPA
Suffix:
Gender:F
Credentials:RD,CDE
Other - Prefix:
Other - First Name:DOROTHEA
Other - Middle Name:OLGA
Other - Last Name:MICHALIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD,CDE
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 E EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2833
Practice Address - Country:US
Practice Address - Phone:650-934-7177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA801578133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered