Provider Demographics
NPI:1801228283
Name:COWDREY, PAULA KAY (RD)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:KAY
Last Name:COWDREY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 W SEQUOIA CIR
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-2776
Mailing Address - Country:US
Mailing Address - Phone:559-356-2361
Mailing Address - Fax:
Practice Address - Street 1:380 N. RESERVATION ROAD
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93258
Practice Address - Country:US
Practice Address - Phone:559-784-2316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA708150133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered