Provider Demographics
NPI:1295427177
Name:KAUFFMAN, HANNAH MICHELLE (RDN)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MICHELLE
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:MICHELLE
Other - Last Name:KOESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:1624 30TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-1422
Mailing Address - Country:US
Mailing Address - Phone:636-328-6873
Mailing Address - Fax:
Practice Address - Street 1:1624 30TH ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92102-1422
Practice Address - Country:US
Practice Address - Phone:636-328-6873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86102633133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered