Provider Demographics
NPI:1437377157
Name:WORKMAN, EMILY GRACE (RD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:GRACE
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:GRACE
Other - Last Name:CROWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:23897 VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:QUAIL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92587-9505
Mailing Address - Country:US
Mailing Address - Phone:951-687-2800
Mailing Address - Fax:
Practice Address - Street 1:4361 LATHAM ST
Practice Address - Street 2:SUITE 150
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-1730
Practice Address - Country:US
Practice Address - Phone:951-687-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL930829133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered