Provider Demographics
NPI:1134884380
Name:NAPIENTEK, NICOLE DENISE (RD)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:DENISE
Last Name:NAPIENTEK
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 1:56739 DESERT GOLD DR
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-4307
Mailing Address - Country:US
Mailing Address - Phone:760-550-5683
Mailing Address - Fax:
Practice Address - Street 1:56739 DESERT GOLD DR
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-4307
Practice Address - Country:US
Practice Address - Phone:760-550-5683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA990811133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA990811OtherCOMMISSION ON DIETETIC REGISTRATION