Provider Demographics
NPI:1316594781
Name:ALMANZA, NICOLE (RD, CDCES, CHES)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ALMANZA
Suffix:
Gender:F
Credentials:RD, CDCES, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 PESETAS LN
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1416
Mailing Address - Country:US
Mailing Address - Phone:805-681-7820
Mailing Address - Fax:
Practice Address - Street 1:215 PESETAS LN
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1416
Practice Address - Country:US
Practice Address - Phone:805-681-7820
Practice Address - Fax:805-679-8308
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28752174H00000X
CA86021289133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174H00000XOther Service ProvidersHealth Educator