Individual provider · NPI-1

Coorina Ayala, RD

Dietitian, Registered · San Jose, CA

NPI number1245433341
StatusActive
Last updated in NPPESJan 6, 2023

Details

NPI
1245433341
Entity type
Individual (NPI-1)
Name
Coorina Ayala
Credential
RD
Sex
Female
Sole proprietor
No
Enumeration date
Jun 6, 2007
Certification date
Jan 6, 2023
Last updated
Jan 6, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered893760CAYes
174400000X Specialist21800673CA
174N00000X Lactation Consultant, Non-RNL-19266–

Practice location

500 Tully Rd
San Jose, CA 95111-1917

Phone 888-334-1000

Mailing address

632 E Alisal St
Salinas, CA 93905-2602

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