Doctor Name: | STACEY BOEK-DOMINGUEZ |
NPI Number: | 1497173157 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., R.D. |
License Number: | 1019706 |
Business Practice Address: | 2550 Sister Mary Columba Dr Red Bluff, CA - 960804327 |
Business Phone Number: | 5305298113 |
Business Fax Number: | 5302422509 |
Mailing Address: | 2550 Sister Mary Columba Dr, RED BLUFF |
State: | CA |
Postal Code: | 960804327 |
Phone Number: | 5305298113 |
Fax Number: | 5302422509 |
NPI Enumeration Date: | 03/31/2014 |
NPI Last Update Date: | 03/31/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 1019706 |
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 |