Provider Demographics
NPI:1134684236
Name:TROUTNER, CHRISTINA (MS, RDN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:TROUTNER
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6370 LUSK BLVD STE F205
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2755
Mailing Address - Country:US
Mailing Address - Phone:858-224-9879
Mailing Address - Fax:
Practice Address - Street 1:6370 LUSK BLVD STE F205
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2755
Practice Address - Country:US
Practice Address - Phone:858-224-9879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1052888133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty