Provider Demographics
NPI:1598264293
Name:PACIFIC NUTRITION PARTNERS, LLC
Entity Type:Organization
Organization Name:PACIFIC NUTRITION PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:310-801-3418
Mailing Address - Street 1:4160 KLUMP AVE
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91602-3314
Mailing Address - Country:US
Mailing Address - Phone:310-801-3418
Mailing Address - Fax:
Practice Address - Street 1:4160 KLUMP AVE
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91602-3314
Practice Address - Country:US
Practice Address - Phone:310-801-3418
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty