Provider Demographics
NPI:1477150472
Name:LINBERG, BROOKE (RDN)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:
Last Name:LINBERG
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22121 CLARENDON ST APT 437
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6291
Mailing Address - Country:US
Mailing Address - Phone:608-780-1740
Mailing Address - Fax:
Practice Address - Street 1:2660 TOWNSGATE RD STE 610
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-5709
Practice Address - Country:US
Practice Address - Phone:805-267-9338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-03
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86115937133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI86115937OtherCOMMISSION ON DIETETIC REGISTRATION