Provider Demographics
NPI:1700256435
Name:LOOPER, FILIPINAS ZARCILLA
Entity Type:Individual
Prefix:
First Name:FILIPINAS
Middle Name:ZARCILLA
Last Name:LOOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19087 SYCAMORE GLEN DR
Mailing Address - Street 2:
Mailing Address - City:TRABUCO CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:92679-1082
Mailing Address - Country:US
Mailing Address - Phone:949-231-9648
Mailing Address - Fax:
Practice Address - Street 1:19087 SYCAMORE GLEN DR
Practice Address - Street 2:
Practice Address - City:TRABUCO CANYON
Practice Address - State:CA
Practice Address - Zip Code:92679-1082
Practice Address - Country:US
Practice Address - Phone:949-231-9648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA853354133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered