Individual
PHYLLIS BERGIE-MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
144 STONY POINT RD, SANTA ROSA, CA 95401-4122
(707) 521-4649
(707) 521-4628
Mailing address
144 STONY POINT RD, SANTA ROSA, CA 95401-4122
(707) 521-4649
(707) 521-4628
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
01/20/2009
Last updated
04/29/2010
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