Individual
MRS. HEIDI BETH BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5435 CITRUS COLONY RD, LOOMIS, CA 95650-8926
(530) 401-8509
Mailing address
5435 CITRUS COLONY RD, LOOMIS, CA 95650-8926
(530) 401-8509
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
946691
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
946691
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
11/05/2018
Last updated
11/05/2018
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