Princess Medina, RD
Dietitian, Registered in Santa Clara, CA. Individual provider (NPI-1).
NPI number1316632086
StatusActive
Last updated in NPPESApr 10, 2023
Details
- NPI
- 1316632086
- Entity type
- Individual (NPI-1)
- Name
- Princess Medina
- Credential
- RD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 10, 2023
- Certification date
- Apr 8, 2023
- Last updated
- Apr 10, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | – | – | Yes |
Practice location
700 Lawrence ExpySanta Clara, CA 95051-5173
Phone 408-851-0400
Mailing address
1948 Via Reggio CtSan Jose, CA 95132-3720
Phone 408-623-0601
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