Individual
CORINNE ROSE KOHLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
77 CASA ST, SUITE 204, SAN LUIS OBISPO, CA 93405-5803
(805) 548-8585
(805) 548-8589
Mailing address
359 LOS CERROS DR, SAN LUIS OBISPO, CA 93405-1272
(805) 441-2281
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
133VN1005X
Renal Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1001966
AMERICAN DIABETIC ASSOCIATION REGISTRATION
CA
01
—
451935
NAT'L KIDNEY FOUNDATION COUNCIL ON RENAL NUTRITION MEMBER
CA
Enumeration date
11/06/2009
Last updated
04/12/2010
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