Provider Demographics
NPI:1457776460
Name:LAMORINDA FAMILY NUTRITION
Entity Type:Organization
Organization Name:LAMORINDA FAMILY NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, CLT
Authorized Official - Phone:925-360-0061
Mailing Address - Street 1:938 DEWING AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4271
Mailing Address - Country:US
Mailing Address - Phone:925-360-0061
Mailing Address - Fax:925-385-7019
Practice Address - Street 1:938 DEWING AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4271
Practice Address - Country:US
Practice Address - Phone:925-360-0061
Practice Address - Fax:925-385-7019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center