Provider Demographics
NPI:1316161086
Name:PEDREGON, DIANN F (RD)
Entity type:Individual
Prefix:MS
First Name:DIANN
Middle Name:F
Last Name:PEDREGON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-1538
Mailing Address - Country:US
Mailing Address - Phone:714-748-2731
Mailing Address - Fax:
Practice Address - Street 1:200 N LEWIS ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-1538
Practice Address - Country:US
Practice Address - Phone:714-748-2731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered