Provider Demographics
NPI:1972813681
Name:PAUL, KRISTINA MORGAN (MS, RD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MORGAN
Last Name:PAUL
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6876 HYDE PARK DR.
Mailing Address - Street 2:UNIT B
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92119
Mailing Address - Country:US
Mailing Address - Phone:858-354-1326
Mailing Address - Fax:
Practice Address - Street 1:6876 HYDE PARK DR.
Practice Address - Street 2:UNIT B
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92119-2288
Practice Address - Country:US
Practice Address - Phone:858-354-1326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1039324133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered