Provider Demographics
NPI:1861539157
Name:MABUBAY, MELINDA MENEZ (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:MENEZ
Last Name:MABUBAY
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:MELINDA MENEZ
Other - Last Name:MABUBAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2662 BELMONT CANYON ROAD
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002
Mailing Address - Country:US
Mailing Address - Phone:650-593-4946
Mailing Address - Fax:
Practice Address - Street 1:1150 VETERANS BOULEVARD
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063
Practice Address - Country:US
Practice Address - Phone:650-299-3164
Practice Address - Fax:650-299-3553
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered