Provider Demographics
NPI:1750412771
Name:MONASTRA, MICHELLE (RD)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:MONASTRA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 MODOC DR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-4160
Mailing Address - Country:US
Mailing Address - Phone:530-892-8733
Mailing Address - Fax:
Practice Address - Street 1:1780 MODOC DR
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-4160
Practice Address - Country:US
Practice Address - Phone:530-892-8733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered