Provider Demographics
NPI:1982988317
Name:VEGA, CHARMENE MARJORIE (MS)
Entity Type:Individual
Prefix:
First Name:CHARMENE
Middle Name:MARJORIE
Last Name:VEGA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MAMA
Other - Middle Name:
Other - Last Name:VEGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10015 CINDERELLA AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-2994
Mailing Address - Country:US
Mailing Address - Phone:661-532-8342
Mailing Address - Fax:
Practice Address - Street 1:10015 CINDERELLA AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-2994
Practice Address - Country:US
Practice Address - Phone:616-532-8342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No133N00000XDietary & Nutritional Service ProvidersNutritionist