Provider Demographics
NPI:1316551450
Name:KAIDA, LAUREN (RD)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:KAIDA
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 1:2355 CONEJO CT
Mailing Address - Street 2:
Mailing Address - City:LOS OSOS
Mailing Address - State:CA
Mailing Address - Zip Code:93402-4015
Mailing Address - Country:US
Mailing Address - Phone:805-459-4457
Mailing Address - Fax:
Practice Address - Street 1:2355 CONEJO CT
Practice Address - Street 2:
Practice Address - City:LOS OSOS
Practice Address - State:CA
Practice Address - Zip Code:93402-4015
Practice Address - Country:US
Practice Address - Phone:805-459-4457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-05
Last Update Date:2020-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86112207133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered