# WEIGHT AWAY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952615957
- **Authorized official:** JESSICA THACS M.A. (OFFICE MANAGER)
- **Authorized official phone:** (559) 297-7565

## Contact information

- **Practice address:** 1895 HERNDON AVE, SUITE 105, CLOVIS, CA 93611
- **Practice address phone:** (559) 297-7563
- **Mailing address:** 255 W BULLARD, SUITE 109, CLOVIS, CA 93612
- **Mailing address phone:** (559) 297-7563
- **Mailing address fax:** (559) 297-5374

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 133NN1002X | Nutrition Education Nutritionist | 00A786030 | CA | Yes |

## Other

- **Enumeration date:** 08/02/2010
- **Last updated:** 08/02/2010