Provider Demographics
NPI:1598001950
Name:STOGSDILL, REBECCA LYNNE (RD, CNSC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYNNE
Last Name:STOGSDILL
Suffix:
Gender:F
Credentials:RD, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9401 CHIVERS AVE
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2655
Mailing Address - Country:US
Mailing Address - Phone:818-351-3084
Mailing Address - Fax:818-252-3892
Practice Address - Street 1:9401 CHIVERS AVE
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-2655
Practice Address - Country:US
Practice Address - Phone:818-351-3084
Practice Address - Fax:818-252-3892
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA01032532133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered