Provider Demographics
NPI:1538533872
Name:DI LAURO, KATHERINE ZOA (RDN)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ZOA
Last Name:DI LAURO
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3087 CORTE TRABUCO
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-4554
Mailing Address - Country:US
Mailing Address - Phone:949-338-5197
Mailing Address - Fax:
Practice Address - Street 1:3087 CORTE TRABUCO
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-4554
Practice Address - Country:US
Practice Address - Phone:949-338-5197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86044969133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered