Provider Demographics
NPI:1952717605
Name:NEBRES, WINIFRED
Entity Type:Individual
Prefix:
First Name:WINIFRED
Middle Name:
Last Name:NEBRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-5656
Mailing Address - Country:US
Mailing Address - Phone:530-751-4270
Mailing Address - Fax:530-749-4337
Practice Address - Street 1:726 4TH ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-5656
Practice Address - Country:US
Practice Address - Phone:530-751-4270
Practice Address - Fax:530-749-4337
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86011486133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered