Provider Demographics
NPI:1104794502
Name:BAINS, AMRITA (RD)
Entity type:Individual
Prefix:
First Name:AMRITA
Middle Name:
Last Name:BAINS
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 1:1870 KENNETH WAY
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-8917
Mailing Address - Country:US
Mailing Address - Phone:530-788-5015
Mailing Address - Fax:
Practice Address - Street 1:1870 KENNETH WAY
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-8917
Practice Address - Country:US
Practice Address - Phone:530-788-5015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86042602133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered