Individual
COLLEEN SKY BAUCOM-PRO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2221 STOCKTON BLVD, 3RD FLOOR, SACRAMENTO, CA 95817-1418
(916) 734-7260
Mailing address
2039 ALTA LOMA ST, DAVIS, CA 95616-0713
(916) 233-6110
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
944951
CA
Other
Enumeration date
11/28/2005
Last updated
07/08/2007
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