Individual
KELSY BONNET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11980 CANARY CT, GRAND TERRACE, CA 92313-5317
(949) 630-6099
Mailing address
24042 SILVERBAY DR, LAKE FOREST, CA 92630-5148
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
86106455
—
133V00000X
Registered Dietitian
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
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NO OTHER IDENTIFIER
—
Enumeration date
08/25/2021
Last updated
05/10/2023
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