Provider Demographics
NPI:1245900067
Name:TAKENAWA, NORIKO (MPH, RDN)
Entity type:Individual
Prefix:
First Name:NORIKO
Middle Name:
Last Name:TAKENAWA
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:NORIKO
Other - Middle Name:
Other - Last Name:FERNANDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2100 NAPA VALLEJO HWY
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6293
Mailing Address - Country:US
Mailing Address - Phone:707-253-5000
Mailing Address - Fax:
Practice Address - Street 1:2100 NAPA VALLEJO HWY
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6293
Practice Address - Country:US
Practice Address - Phone:707-253-5654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered