Alice Dale Waterbury Fagundes MS, RDN

NPI 1437482932 - Dietitian, Registered - 133V00000X

NPI Details
NPI 1437482932
Gender Female
Enumeration Date 09/15/2009
Last Updated 09/09/2013
Entity Type Individual
Active Over 7 years ago
Practice Location
175 N JACKSON AVE
SUITE 209
SAN JOSE CA, 95116-1909, US
Phone (408) 568-4181
Fax (408) 516-9042
Business Location
175 N JACKSON AVE
SUITE 209
SAN JOSE CA, 95116-1909, US
Phone (408) 568-4181
Fax (408) 516-9042
Toxanomy
Taxonomy Code 133V00000X
License State California
License Number 970752
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According to our database, Mrs. Alice Dale Waterbury Fagundes MS, RDN NPI is 1437482932, taxonomy code is 133V00000X and license number is 970752, license state is located at California. Alice Dale Waterbury Fagundes MS, RDN physically located at 175 N Jackson Ave, San Jose CA, 95116-1909. NPI Number Alice Dale Waterbury Fagundes MS, RDN has the Individual type.

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1437482932 NPI number is provided on an as is basis without warranty of any kind. 1437482932 is maintained by the National Plan & Provider Enumeration System. The contents of Alice Dale Waterbury Fagundes MS, RDN are for informational purposes only.