Individual
MRS. LINDA VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CDE
Contact information
Practice address
1129 RED TAIL WAY, SIMI VALLEY, CA 93065-7232
(805) 558-8343
(805) 334-6377
Mailing address
14442 RUTGER CIR, MOORPARK, CA 93021-1323
(805) 558-8343
(805) 334-6377
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
579172
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MNT579172
MEDICAL NUTRITION THERAPY
CA
Enumeration date
07/03/2006
Last updated
09/30/2015
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