Provider Demographics
NPI:1164658563
Name:LOY, MICHELLE (MPH, MS, RD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:LOY
Suffix:
Gender:F
Credentials:MPH, MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15301 CASCADE LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3011
Mailing Address - Country:US
Mailing Address - Phone:714-852-8397
Mailing Address - Fax:
Practice Address - Street 1:15301 CASCADE LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3011
Practice Address - Country:US
Practice Address - Phone:714-852-8397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered