| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ELLEN M ALONSO STREET | 1760099097 | 2023-08-12 |
Ellen M Alonso Street is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1760099097. Registration indicates Ellen M Alonso Street is a provider of services with a specialization in Dietary & Nutritional Service Providers, Dietitian, Registered (Dietitian, Registered, ) (All Other Specialties & Provider Types, ) (Dietitian, Registered, Dietary & Nutritional Service Providers)
| Entity Type | Individual |
| Provider Name | Ms. Ellen M Alonso Street MS, R.D. |
| Other Provider Name | Ms. Ellen M Street |
| Practice Office Address | 2628 INTERNATIONAL BLVD OAKLAND, CA US |
| Practice Office Telephone | 1052618219 |
| Mailing Address | 2628 INTERNATIONAL BLVD OAKLAND, CA 946011512 US |
| Business Telephone | 1052618219 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 2070 Clinton Ave | Alameda, CA 945014397 | 5105223700 |
| Code | Practice | License No State |
|---|---|---|
| 133V00000X PRIMARY | Dietary & Nutritional Service Providers Dietitian, Registered Dietitian, Registered All Other Specialties & Provider Types Dietitian, Registered Dietary & Nutritional Service Providers | 86176658
CA |