Individual
MRS. KELLY SHEPPARD LOUGHLIN-
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN, CDCES
Contact information
Practice address
18865 VISTA PORTOLA, TRABUCO CANYON, CA 92679-1101
(760) 641-4129
(760) 641-4129
Mailing address
18865 VISTA PORTOLA, TRABUCO CANYON, CA 92679-1101
(760) 641-4129
(760) 641-4129
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
2031-0259
CA
133V00000X
Registered Dietitian
Primary
852172
CA
133V00000X
Registered Dietitian
852172
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2031-0259
CDE
CA
01
—
852172
CDR
CA
Enumeration date
02/16/2009
Last updated
03/07/2020
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