Provider Demographics
NPI:1972056125
Name:BARTLEBAUGH, MAUREEN (MSHS, RDN, CNSC)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:
Last Name:BARTLEBAUGH
Suffix:
Gender:F
Credentials:MSHS, RDN, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 ROSSMOOR PKWY
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94595-2501
Mailing Address - Country:US
Mailing Address - Phone:925-937-7450
Mailing Address - Fax:
Practice Address - Street 1:1224 ROSSMOOR PKWY
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94595-2501
Practice Address - Country:US
Practice Address - Phone:925-937-7450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-24
Last Update Date:2016-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered