| Doctor Name: | CHRISTINA M BECERRA |
| NPI Number: | 1023248036 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD, LD, CPT |
| License Number: | 792 |
| Business Practice Address: | 711 Marshall St Leavenworth, KS - 660483235 |
| Business Phone Number: | 9136841100 |
| Business Fax Number: | |
| Mailing Address: | 29800 W 119th St, OLATHE |
| State: | KS |
| Postal Code: | 660618621 |
| Phone Number: | 9133979017 |
| Fax Number: | |
| NPI Enumeration Date: | 07/24/2009 |
| NPI Last Update Date: | 07/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1005X |
| License Number: | 792 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Renal |
| Taxonomy Definition: | |