Provider Demographics
NPI:1346541653
Name:CAILLE, BRIGITTE ANNE (RD)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:ANNE
Last Name:CAILLE
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 1:11177 TAMPA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-2254
Mailing Address - Country:US
Mailing Address - Phone:818-831-8000
Mailing Address - Fax:818-831-8005
Practice Address - Street 1:11177 TAMPA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-2254
Practice Address - Country:US
Practice Address - Phone:818-831-8000
Practice Address - Fax:818-831-8005
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA913947133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered