Provider Demographics
NPI:1295160885
Name:TRIVEDI, PRAKRUTIPRIYA (MS, RD)
Entity type:Individual
Prefix:
First Name:PRAKRUTIPRIYA
Middle Name:
Last Name:TRIVEDI
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 VALLOMBROSA AVE
Mailing Address - Street 2:37
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-4079
Mailing Address - Country:US
Mailing Address - Phone:530-521-7387
Mailing Address - Fax:
Practice Address - Street 1:25 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95929-0235
Practice Address - Country:US
Practice Address - Phone:530-521-7387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered