Provider Demographics
NPI:1083318125
Name:BURNELL, KALYN (RD)
Entity Type:Individual
Prefix:MRS
First Name:KALYN
Middle Name:
Last Name:BURNELL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9536 JONES AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:CA
Mailing Address - Zip Code:95938-9721
Mailing Address - Country:US
Mailing Address - Phone:530-586-0111
Mailing Address - Fax:
Practice Address - Street 1:265 COHASSET RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2273
Practice Address - Country:US
Practice Address - Phone:530-332-3917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered