Provider Demographics
NPI:1104649185
Name:DELGADO, JENALYN EVE SACRAMENTO (RDN)
Entity type:Individual
Prefix:
First Name:JENALYN EVE
Middle Name:SACRAMENTO
Last Name:DELGADO
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 CARPENTIER ST
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3526
Mailing Address - Country:US
Mailing Address - Phone:510-575-5185
Mailing Address - Fax:
Practice Address - Street 1:1888 CARPENTIER ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-3526
Practice Address - Country:US
Practice Address - Phone:510-575-5185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86062200133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered