Provider Demographics
NPI:1174848634
Name:BENOIT, NANCY ANN (MS RD)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:BENOIT
Suffix:
Gender:F
Credentials: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:PO BOX 1054
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-0105
Mailing Address - Country:US
Mailing Address - Phone:916-215-0696
Mailing Address - Fax:
Practice Address - Street 1:8656 MERRIBROOK DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3128
Practice Address - Country:US
Practice Address - Phone:916-215-0696
Practice Address - Fax:925-267-4299
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-28
Last Update Date:2010-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
R016115133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered