Provider Demographics
NPI:1619586609
Name:NUTRICIUS CONSULTING SERVICES
Entity Type:Organization
Organization Name:NUTRICIUS CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCCREA
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:209-421-0841
Mailing Address - Street 1:PO BOX 1370
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-1370
Mailing Address - Country:US
Mailing Address - Phone:209-421-0841
Mailing Address - Fax:
Practice Address - Street 1:1000 W YOSEMITE AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-5111
Practice Address - Country:US
Practice Address - Phone:209-783-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty