| Doctor Name: | MRS. ALICE DALE WATERBURY FAGUNDES |
| NPI Number: | 1437482932 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, RDN |
| License Number: | 970752 |
| Business Practice Address: | 175 N Jackson Ave Suite 209 San Jose, CA - 951161909 |
| Business Phone Number: | 4085684181 |
| Business Fax Number: | 4085169042 |
| Mailing Address: | 175 N Jackson Ave, Suite 209 SAN JOSE |
| State: | CA |
| Postal Code: | 951161909 |
| Phone Number: | 4085684181 |
| Fax Number: | 4085169042 |
| NPI Enumeration Date: | 09/15/2009 |
| NPI Last Update Date: | 09/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 970752 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |