Provider Demographics
NPI:1457538076
Name:CHA, RENEE L (RD)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:L
Last Name:CHA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:RENEE
Other - Middle Name:L
Other - Last Name:DEGRAAF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:92-7147 ELELE ST
Mailing Address - Street 2:# 1201
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-3388
Mailing Address - Country:US
Mailing Address - Phone:765-631-2891
Mailing Address - Fax:
Practice Address - Street 1:98-1079 MOANALUA RD
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4713
Practice Address - Country:US
Practice Address - Phone:808-485-4371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered