Individual
REBECCA GAIL MCKENZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18300 CA-18, APPLE VALLEY, CA 92307
(760) 242-2311
Mailing address
6382 N BRENDA LN, SAN BERNARDINO, CA 92407-4039
(909) 965-2880
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
86075778
CA
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
86075778
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86075778
ACADEMY OF NUTRITION AND DIETETICS
CA
Enumeration date
01/31/2019
Last updated
01/31/2019
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