Provider Demographics
NPI:1912495730
Name:MINEO, GINA MARIE (RD)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:MINEO
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 1:632 E ALISAL ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-2602
Mailing Address - Country:US
Mailing Address - Phone:831-393-3251
Mailing Address - Fax:831-393-3253
Practice Address - Street 1:632 E ALISAL ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-2602
Practice Address - Country:US
Practice Address - Phone:831-393-3251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA803976133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered