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Individual

KENNORIS D. BATES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
847 WEST CHILDS AVENUE, MERCED, CA 95340-6805
(209) 383-7441
(209) 383-6198
Mailing address
737 WEST CHILDS AVENUE, MERCED, CA 95340-6805
(209) 383-1848
(209) 384-3966

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
RD899190
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RD899190
REGISTERED DIETITIAN
CA
Enumeration date
04/18/2007
Last updated
07/08/2007
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