Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. MARA DA LUZ BERNARDO, RDN, CSO
ActiveOncology Nutrition · STOCKTON, CA
Registration Details
- NPI Number
- 1255904512
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 22, 2021 (4.7510426522746 yrs)
- Last Updated
- Sep 20, 2023
- Licenses
-
86033078 (CA)86033078 (CA)
Practice Information
- Address
-
415 W BENJAMIN HOLT DR STE B3STOCKTON, CA, 952073958Browse CA providers · Browse ZIP 95207
- Phone
- 2092270722
- Fax
- 8668628832
- Primary Specialty
-
Oncology Nutrition
133VN1301X
- Additional Specialty
- Oncology Nutrition
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.