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Organization
CLOUDBERRY NUTRITION LLC
Active
Organization
CLOUDBERRY NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNA FAYCURRY (EMPLOYEE)
(847) 224-6168
Entity
Organization
Contact information
Practice address
2541 BACK BAY LOOP, COSTA MESA, CA 92627-5421
(847) 224-6168
Mailing address
2541 BACK BAY LOOP, COSTA MESA, CA 92627-5421
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
NULL
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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