Provider Demographics
NPI:1093935496
Name:DELAURIER, KATI L (MS,RD,CLE)
Entity Type:Individual
Prefix:
First Name:KATI
Middle Name:L
Last Name:DELAURIER
Suffix:
Gender:F
Credentials:MS,RD,CLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5181
Mailing Address - Street 2:
Mailing Address - City:FRAZIER PARK
Mailing Address - State:CA
Mailing Address - Zip Code:93222-5181
Mailing Address - Country:US
Mailing Address - Phone:661-242-8117
Mailing Address - Fax:
Practice Address - Street 1:1524 27TH ST STE 101
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2056
Practice Address - Country:US
Practice Address - Phone:661-869-6581
Practice Address - Fax:661-321-2213
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA722781133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered