Provider Demographics
NPI:1396484796
Name:REINKE, ASHLEY (MS, RD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:REINKE
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 1:23747 OAKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HIDDEN HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-2413
Mailing Address - Country:US
Mailing Address - Phone:520-548-9473
Mailing Address - Fax:
Practice Address - Street 1:23747 OAKFIELD RD
Practice Address - Street 2:
Practice Address - City:HIDDEN HILLS
Practice Address - State:CA
Practice Address - Zip Code:91302-2413
Practice Address - Country:US
Practice Address - Phone:520-548-9473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86298308133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered