Provider Demographics
NPI:1790372449
Name:NOURISHED WITH KINDNESS
Entity Type:Organization
Organization Name:NOURISHED WITH KINDNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN
Authorized Official - Phone:805-267-9338
Mailing Address - Street 1:3198 THISTLEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-2885
Mailing Address - Country:US
Mailing Address - Phone:805-267-9338
Mailing Address - Fax:
Practice Address - Street 1:2660 TOWNSGATE RD STE 610
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-5709
Practice Address - Country:US
Practice Address - Phone:805-267-9338
Practice Address - Fax:805-930-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty