Provider Demographics
NPI:1407088404
Name:ROMO, MEGAN LYNN (RD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYNN
Last Name:ROMO
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 1:206 VIA MORELLA
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-5390
Mailing Address - Country:US
Mailing Address - Phone:206-228-4992
Mailing Address - Fax:
Practice Address - Street 1:206 VIA MORELLA
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5390
Practice Address - Country:US
Practice Address - Phone:206-228-4992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01026250133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered