Individual
KELLEY BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., R.D.
Contact information
Practice address
13851 E 14TH ST, SUITE 102, SAN LEANDRO, CA 94578-2631
(510) 351-2100
Mailing address
2201 WEST 135TH AVE., SAN LEANDRO, CA 94577-4115
(510) 483-5036
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1012906
CA
Other
Enumeration date
02/21/2012
Last updated
02/21/2012
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