Provider Demographics
NPI:1760780944
Name:HACKERT, APRIL N (MS, RDN, LPN,CEDRD-S)
Entity Type:Individual
Prefix:PROF
First Name:APRIL
Middle Name:N
Last Name:HACKERT
Suffix:
Gender:F
Credentials:MS, RDN, LPN,CEDRD-S
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:N
Other - Last Name:WINSLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD
Mailing Address - Street 1:PO BOX 9531
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96158
Mailing Address - Country:US
Mailing Address - Phone:831-204-8344
Mailing Address - Fax:408-625-6248
Practice Address - Street 1:701 MISSION ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-3614
Practice Address - Country:US
Practice Address - Phone:831-204-8344
Practice Address - Fax:408-625-6248
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-11
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
915311133VN1004X
CA915311133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric