Provider Demographics
NPI:1790558906
Name:LIFEWEIGHT NUTRITION PROGRAMS
Entity Type:Organization
Organization Name:LIFEWEIGHT NUTRITION PROGRAMS
Other - Org Name:LINDA MICHAELIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:MICHAELIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD
Authorized Official - Phone:925-855-0150
Mailing Address - Street 1:250 SAINT PAUL DR
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-1648
Mailing Address - Country:US
Mailing Address - Phone:925-855-0150
Mailing Address - Fax:925-362-0806
Practice Address - Street 1:250 SAINT PAUL DR
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:CA
Practice Address - Zip Code:94507-1648
Practice Address - Country:US
Practice Address - Phone:925-855-0150
Practice Address - Fax:925-362-0806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty