Erva Santoso, RDN
Dietitian, Registered in Fort Bliss, TX. Individual provider (NPI-1).
NPI number1962032045
StatusActive
Last updated in NPPESJul 29, 2025
Details
- NPI
- 1962032045
- Entity type
- Individual (NPI-1)
- Name
- Erva Santoso
- Credential
- RDN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 17, 2020
- Certification date
- Jul 29, 2025
- Last updated
- Jul 29, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 1072186 | – | Yes |
| 133V00000X | Dietitian, Registered | 205-LD | HI |
Practice location
18511 Highlander Medics StFort Bliss, TX 79906-5327
Phone 718-360-7472
Mailing address
11400 Edgemere Blvd Apt 3113El Paso, TX 79936-2426
Phone 718-360-7472
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