Provider Demographics
NPI:1841724374
Name:BECERRA, SILVIA E (MS, RDN, CDCEN, CLEC)
Entity type:Individual
Prefix:
First Name:SILVIA
Middle Name:E
Last Name:BECERRA
Suffix:
Gender:F
Credentials:MS, RDN, CDCEN, CLEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 N TEXAS ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-5623
Mailing Address - Country:US
Mailing Address - Phone:818-745-7438
Mailing Address - Fax:
Practice Address - Street 1:1545 N TEXAS ST STE 201
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-5623
Practice Address - Country:US
Practice Address - Phone:818-745-7438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1036133133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered