Individual
KYLIE KING VANOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D.
Contact information
Practice address
3401 BARHAM BLVD, SUITE 4, LOS ANGELES, CA 90068-1289
(323) 422-0222
Mailing address
12946 VALLEYHEART DRIVE, SUITE 213, STUDIO CITY, CA 91604-1971
(323) 422-0222
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
—
—
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
10/13/2015
Last updated
11/03/2020
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