Individual
KELLY BARNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11705 LOISDALE WAY, RANCHO CORDOVA, CA 95742-8028
(916) 208-0552
Mailing address
11705 LOISDALE WAY, RANCHO CORDOVA, CA 95742-8028
(916) 208-0552
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
931140
CA
Other
Enumeration date
05/12/2020
Last updated
05/12/2020
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