Provider Demographics
NPI:1114678844
Name:ACUNA, KRISTI (BSNU)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:ACUNA
Suffix:
Gender:F
Credentials:BSNU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 QUAIL ST STE 105
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-2747
Mailing Address - Country:US
Mailing Address - Phone:949-742-2749
Mailing Address - Fax:
Practice Address - Street 1:1451 QUAIL ST STE 105
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2747
Practice Address - Country:US
Practice Address - Phone:949-742-2749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education