Individual provider · NPI-1

Jacqueline Carbajal

Dietitian, Registered · Glendale, AZ

NPI number1003726381
StatusActive
Last updated in NPPESSep 9, 2026

Details

NPI
1003726381
Entity type
Individual (NPI-1)
Name
Jacqueline Carbajal
Sex
Female
Sole proprietor
No
Enumeration date
Sep 9, 2026
Certification date
Sep 9, 2026
Last updated
Sep 9, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered86374859AZYes

Practice location

18001 N 79th Ave Ste A12
Glendale, AZ 85308-8398

Phone 623-399-6825 · Fax 623-505-3474

Mailing address

18001 N 79th Ave Ste A12
Glendale, AZ 85308-8398

Phone 623-399-6825 · Fax 623-505-3474

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dietitian, Registered providers in Glendale, AZ