Provider Demographics
NPI:1285142372
Name:REGALADO, ALEXANDRA (RD, LDN)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:REGALADO
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 WARREN WAY
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-3627
Mailing Address - Country:US
Mailing Address - Phone:650-387-7141
Mailing Address - Fax:
Practice Address - Street 1:880 WARREN WAY
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-3627
Practice Address - Country:US
Practice Address - Phone:650-387-7141
Practice Address - Fax:877-743-5351
Is Sole Proprietor?:No
Enumeration Date:2018-01-11
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86093783133V00000X
MA86093783133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered