Provider Demographics
NPI:1598542334
Name:CARDLE, KATE (RDN)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:CARDLE
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 1:7406 MONIQUE PL
Mailing Address - Street 2:
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-3640
Mailing Address - Country:US
Mailing Address - Phone:707-231-8923
Mailing Address - Fax:
Practice Address - Street 1:7406 MONIQUE PL
Practice Address - Street 2:
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-3640
Practice Address - Country:US
Practice Address - Phone:707-231-8923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86302743133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered