Provider Demographics
NPI:1912760406
Name:CRAY, CIARA (RD)
Entity Type:Individual
Prefix:
First Name:CIARA
Middle Name:
Last Name:CRAY
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 1:355 LEXINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-2839
Mailing Address - Country:US
Mailing Address - Phone:650-208-2180
Mailing Address - Fax:
Practice Address - Street 1:355 LEXINGTON WAY
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-2839
Practice Address - Country:US
Practice Address - Phone:650-208-0218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86253355133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered