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SUSAN ELAINE KIMPSTON DIETITIAN

>> Dietitian, Registered >> Dietary & Nutritional Service Providers

Registrant NPI Number: 1255477428

Individual Registrant:
 SUSAN ELAINE KIMPSTON DIETITIAN
Gender: F
Sole Proprietor

Location and contact information for practice:
14938 TOURNAMENT DR  HELENDALE, CA 92342-1422 US
Tel: 760-952-2532  Fax: 760-952-2532

Contact information for business:
PO BOX 1422  HELENDALE, CA 92342-1422 US
Tel: 760-952-2532  Fax: 760-952-2532

Registration Information:
NPI: 1255477428
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y133V00000XDietary & Nutritional Service Providers
Dietitian, Registered
CA866288

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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