Provider Demographics
NPI:1437945847
Name:WATFORD, ALI (MS)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:WATFORD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2327 COMSTOCK LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-7526
Mailing Address - Country:US
Mailing Address - Phone:916-770-7002
Mailing Address - Fax:
Practice Address - Street 1:2327 COMSTOCK LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-7526
Practice Address - Country:US
Practice Address - Phone:916-770-7002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education