Doctor Name: | KELLY FAULSTICH |
NPI Number: | 1366838914 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.D. |
License Number: | 1012072 |
Business Practice Address: | 2385 S Melrose Dr Vista, CA - 920818788 |
Business Phone Number: | 7603003647 |
Business Fax Number: | 7604831316 |
Mailing Address: | 2385 S Melrose Dr, VISTA |
State: | CA |
Postal Code: | 920818788 |
Phone Number: | 7603003647 |
Fax Number: | 7604831316 |
NPI Enumeration Date: | 04/10/2015 |
NPI Last Update Date: | 04/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 1012072 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |