Provider Demographics
NPI:1467273714
Name:ZERFAS, CARRIE M (RD)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:M
Last Name:ZERFAS
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 1:1226 CRESCENDO DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5159
Mailing Address - Country:US
Mailing Address - Phone:916-768-6460
Mailing Address - Fax:
Practice Address - Street 1:1451 SECRET RAVINE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-6052
Practice Address - Country:US
Practice Address - Phone:916-724-2595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86314539133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered