Provider Demographics
NPI:1275213209
Name:DOYLE, PAIGE LYNN (RD)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:LYNN
Last Name:DOYLE
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 1:208 PROVIDENCE MINE RD STE 122B
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-2955
Mailing Address - Country:US
Mailing Address - Phone:530-615-4155
Mailing Address - Fax:
Practice Address - Street 1:208 PROVIDENCE MINE RD STE 122B
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2955
Practice Address - Country:US
Practice Address - Phone:530-615-4155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86297012133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered