Provider Demographics
NPI:1952520561
Name:SAN PIETRO, MONVIPA (RD)
Entity Type:Individual
Prefix:MS
First Name:MONVIPA
Middle Name:
Last Name:SAN PIETRO
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 1:384 LEXINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-2840
Mailing Address - Country:US
Mailing Address - Phone:650-375-1079
Mailing Address - Fax:
Practice Address - Street 1:384 LEXINGTON WAY
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-2840
Practice Address - Country:US
Practice Address - Phone:650-375-1079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA345479133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered