Provider Demographics
NPI:1306291109
Name:SIPE, GABRIELA (MED, RDN, LD)
Entity type:Individual
Prefix:MS
First Name:GABRIELA
Middle Name:
Last Name:SIPE
Suffix:
Gender:F
Credentials:MED, RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 CYPRESS HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2394
Mailing Address - Country:US
Mailing Address - Phone:760-212-7093
Mailing Address - Fax:
Practice Address - Street 1:637 CYPRESS HILLS DR
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2394
Practice Address - Country:US
Practice Address - Phone:760-212-7093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
818722133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered