Provider Demographics
NPI:1164906095
Name:WOOLSEY, COURTNEY N (RD)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:N
Last Name:WOOLSEY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:N
Other - Last Name:GOODWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:3951 VAN BUREN BLVD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3620
Mailing Address - Country:US
Mailing Address - Phone:866-883-0119
Mailing Address - Fax:
Practice Address - Street 1:3951 VAN BUREN BLVD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3620
Practice Address - Country:US
Practice Address - Phone:619-823-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-17
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered