Provider Demographics
NPI:1720132244
Name:RAY, RHONDA (RD)
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:
Last Name:RAY
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 1:13942 MERELLO ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92843-3245
Mailing Address - Country:US
Mailing Address - Phone:714-537-3939
Mailing Address - Fax:
Practice Address - Street 1:13942 MERELLO ST
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-3245
Practice Address - Country:US
Practice Address - Phone:714-537-3939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0534121133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered