Sonja R Baca, R.D.

Individual provider Active NPI Registered Dietitian · Gallup, NM

NPI 1205958733 · NPPES record last updated Mar 25, 2015

Key facts

NPI
1205958733
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
485 (NM)
Practice address
1910 Redrock Dr
Gallup, NM 87301-5682
Phone
(505) 863-7250
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 485 NM Yes

Addresses

Primary practice location

1910 Redrock Dr
Gallup, NM 87301-5682

Mailing address

1901 Redrock Dr
PFS Dept
Gallup, NM 87301-5683
Phone (505) 863-7000

Other providers in Gallup, NM

All providers in Gallup, NM · Registered Dietitian in New Mexico

Sources for this page

Verify at the official NPI Registry.