Individual
MRS. ALICE DALE WATERBURY FAGUNDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN
Contact information
Practice address
175 N JACKSON AVE, SUITE 209, SAN JOSE, CA 95116-1909
(408) 568-4181
(408) 516-9042
Mailing address
175 N JACKSON AVE, SUITE 209, SAN JOSE, CA 95116-1909
(408) 568-4181
(408) 516-9042
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
970752
CA
Other
Enumeration date
09/15/2009
Last updated
09/09/2013
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