Individual
KENNETH RYAN HEFFERNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D.
Contact information
Practice address
1945 SHERINGTON PL, APT G313, NEWPORT BEACH, CA 92663-6043
(714) 916-7136
Mailing address
1945 SHERINGTON PL, APT G313, NEWPORT BEACH, CA 92663-6043
(714) 916-7136
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
05/27/2009
Last updated
05/27/2009
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