Individual
JOHN T AZEVEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
9451 WINDRUNNER LN, ELK GROVE, CA 95758-4636
(916) 668-9206
Mailing address
9451 WINDRUNNER LN, ELK GROVE, CA 95758-4636
(209) 604-9003
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86023720
CA
Other
Enumeration date
03/16/2020
Last updated
11/17/2021
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