Provider Demographics
NPI:1427676576
Name:SANCHEZ, MARC REY GARCIA (MS, RD, CSSD, CSOWM)
Entity type:Individual
Prefix:
First Name:MARC REY
Middle Name:GARCIA
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:MS, RD, CSSD, CSOWM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:976 OLDS AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:CA
Mailing Address - Zip Code:95334-1800
Mailing Address - Country:US
Mailing Address - Phone:209-648-6234
Mailing Address - Fax:
Practice Address - Street 1:976 OLDS AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:CA
Practice Address - Zip Code:95334-1800
Practice Address - Country:US
Practice Address - Phone:209-648-6234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1069136133VN1201X, 133VN1501X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
No133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics