NPI 1205958733 · live from the CMS NPI Registry
Sonja R Baca, R.D.
Dietitian, Registered in Gallup, NM. National Provider Identifier 1205958733, active.
NPI record
| NPI | 1205958733 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 1910 Redrock Dr, Gallup, NM 87301 |
| Practice phone | 505-863-7250 |
| Mailing address | 1901 Redrock Dr, Pfs Dept, Gallup, NM 87301 |
| Enumerated | April 4, 2007 |
| Last updated | March 25, 2015 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 485 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.