Provider Demographics
NPI:1386417608
Name:HUICOCHEA, BASIA (NUTRITIONIST)
Entity type:Individual
Prefix:
First Name:BASIA
Middle Name:
Last Name:HUICOCHEA
Suffix:
Gender:F
Credentials:NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 CHERRY AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3910
Mailing Address - Country:US
Mailing Address - Phone:310-529-0762
Mailing Address - Fax:
Practice Address - Street 1:6285 E SPRING ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-4020
Practice Address - Country:US
Practice Address - Phone:562-424-4055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education