Provider Demographics
NPI:1407345341
Name:CONTRERAS, ROSAURA (RD)
Entity type:Individual
Prefix:MRS
First Name:ROSAURA
Middle Name:
Last Name:CONTRERAS
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 1:15115 ROXFORD ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-8372
Mailing Address - Country:US
Mailing Address - Phone:626-277-5392
Mailing Address - Fax:
Practice Address - Street 1:109 WEST 6TH STREET
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702
Practice Address - Country:US
Practice Address - Phone:626-277-5392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-07
Last Update Date:2025-06-03
Deactivation Date:2021-04-27
Deactivation Code:
Reactivation Date:2025-06-03
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered