Individual
KEILA MARINA KERNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2658 PERN PL, SANTA ROSA, CA 95404-5443
(707) 227-6518
Mailing address
2658 PERN PL, SANTA ROSA, CA 95404-5443
(707) 227-6518
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86115720
CA
174N00000X
Lactation Consultant (Non-RN)
L-305401
CA
Other
Enumeration date
03/06/2023
Last updated
03/09/2023
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