Provider Demographics
NPI:1710565163
Name:DESERT NUTRITION AND WELLNESS
Entity Type:Organization
Organization Name:DESERT NUTRITION AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:STANKIS
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:805-801-0122
Mailing Address - Street 1:78365 HIGHWAY 111 # 285
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2071
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:760-300-8385
Practice Address - Street 1:74818 VELIE WAY STE 12
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-1924
Practice Address - Country:US
Practice Address - Phone:760-702-6394
Practice Address - Fax:760-300-3539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty