Provider Demographics
NPI:1356118780
Name:VAZQUEZ, ATALIA (RDN)
Entity type:Individual
Prefix:
First Name:ATALIA
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5146 ENID WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-6058
Mailing Address - Country:US
Mailing Address - Phone:321-745-8922
Mailing Address - Fax:
Practice Address - Street 1:5146 ENID WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-6058
Practice Address - Country:US
Practice Address - Phone:321-745-8922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12705133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered