Provider Demographics
NPI:1407748270
Name:LUBRICO, MADELINE (RD)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:LUBRICO
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 1:537 FARRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-6014
Mailing Address - Country:US
Mailing Address - Phone:916-320-0295
Mailing Address - Fax:
Practice Address - Street 1:537 FARRIDGE DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-6014
Practice Address - Country:US
Practice Address - Phone:916-320-0295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty