Individual
LEAH M TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
84 SANTA ROSA ST, SUITE A, SAN LUIS OBISPO, CA 93405-1812
(805) 548-8585
(805) 548-8589
Mailing address
84 SANTA ROSA ST, SUITE A, SAN LUIS OBISPO, CA 93405-1812
(805) 548-8585
(805) 548-8589
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
919327
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
919327
AMERICAN DIETETIC ASSOCIATION MEMBERSHIP
CA
Enumeration date
01/14/2011
Last updated
11/10/2014
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