Organization
UPSTREAM WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE MICHELLE CARROLL STRUDLEY CNS (FUNCTIONAL NUTRITIONIST)
(831) 337-8435
Entity
Organization
Contact information
Practice address
120 MAYFAIR RD, BOULDER CREEK, CA 95006-9401
(831) 337-8435
Mailing address
120 MAYFAIR RD, BOULDER CREEK, CA 95006-9401
(831) 337-8435
(831) 331-2877
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
Other
Enumeration date
01/31/2026
Last updated
01/31/2026
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