Individual
KELSEY LINN THEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CLEC
Contact information
Practice address
3020 CHILDRENS WAY, SAN DIEGO, CA 92123-4223
(858) 576-1700
Mailing address
2520 TRAIL MARKER PL, CHULA VISTA, CA 91914-4160
(320) 293-9940
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
86102837
CA
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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