Basic Information
| Provider Information | |||||||||
| NPI: | 1740681600 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARREAL | ||||||||
| FirstName: | OLGA | ||||||||
| MiddleName: | TRINIDAD | ||||||||
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| Credential: | DIETITIAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8041 NEWMAN AVE | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926477034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8884999303 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8041 NEWMAN AVE | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926477034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8884999303 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2014 | ||||||||
| LastUpdateDate: | 09/10/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133NN1002X | 264452 | CA | Y | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education |
No ID Information.