Individual
NIA NICOLE CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RYT, RMT
Contact information
Practice address
4114 SWIFT AVE APT 5, SAN DIEGO, CA 92104-2249
(170) 224-4013
Mailing address
4114 SWIFT AVE APT 5, SAN DIEGO, CA 92104-2249
(170) 224-4013
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
Other
Enumeration date
10/11/2018
Last updated
10/11/2018
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