Provider Demographics
NPI:1013362557
Name:TOYA, COURTNEY DAIR (MS, RD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:DAIR
Last Name:TOYA
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 QUAIL ST STE 105
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2711
Mailing Address - Country:US
Mailing Address - Phone:562-480-8757
Mailing Address - Fax:844-825-7716
Practice Address - Street 1:1300 QUAIL ST STE 105
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2711
Practice Address - Country:US
Practice Address - Phone:562-480-8757
Practice Address - Fax:844-825-7716
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2019-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1095807133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered