Provider Demographics
NPI:1740174564
Name:WEST, DAPHNE (RD, LD, CLC)
Entity type:Individual
Prefix:MRS
First Name:DAPHNE
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:RD, LD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 CALIFORNIA ST STE 1400
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-2116
Mailing Address - Country:US
Mailing Address - Phone:212-589-2700
Mailing Address - Fax:
Practice Address - Street 1:1625 DAWNVILLE BEAVERDALE RD NE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-6814
Practice Address - Country:US
Practice Address - Phone:706-581-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD001830133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered