Organization
LIFESTYLE NUTRITION & DIETETICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CAUDILL (RD)
(530) 830-2551
Entity
Organization
Contact information
Practice address
970 RESERVE DR STE 100, ROSEVILLE, CA 95678-1377
(530) 830-2551
(916) 970-0071
Mailing address
9100 SEAVEY LN, LOOMIS, CA 95650-8898
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
07/24/2019
Last updated
02/28/2020
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