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Organization
RENEGADE NUTRITION LLC
Active
Organization
RENEGADE NUTRITION LLC
Active
Other names
Renegade Nutrition LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HOUSER RD (OWNER)
(408) 460-7319
Entity
Organization
Contact information
Practice address
33947 RAILROAD AVE, UNION CITY, CA 94587-3431
(408) 460-7319
Mailing address
33947 RAILROAD AVE, UNION CITY, CA 94587-3431
(408) 460-7319
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205303260
—
CA
Enumeration date
08/18/2020
Last updated
08/18/2020
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