Individual
AMANDA JUAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
215 N FRESNO, SUITE 370, FRESNO, CA 93701
(559) 456-1560
Mailing address
215 N FRESNO, SUITE 370, FRESNO, CA 93701
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1016628
CDR
—
Enumeration date
04/17/2018
Last updated
04/17/2018
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