Provider Demographics
NPI:1205299013
Name:KINDER, COURTNEY KAY (MS, RDN, IFNCP)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:KAY
Last Name:KINDER
Suffix:
Gender:F
Credentials:MS, RDN, IFNCP
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:KAY
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, RD
Mailing Address - Street 1:1264 HIGUERA ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-3171
Mailing Address - Country:US
Mailing Address - Phone:805-439-4706
Mailing Address - Fax:
Practice Address - Street 1:1264 HIGUERA ST STE 102
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3171
Practice Address - Country:US
Practice Address - Phone:805-439-4706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered