Provider Demographics
NPI:1720652118
Name:UPBEET NUTRITION, INC
Entity Type:Organization
Organization Name:UPBEET NUTRITION, INC
Other - Org Name:UPBEET NUTRITION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONA LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:559-352-5242
Mailing Address - Street 1:1064 MILL ST
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-4602
Mailing Address - Country:US
Mailing Address - Phone:559-352-5242
Mailing Address - Fax:559-891-7542
Practice Address - Street 1:1915 HIGH ST
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-3510
Practice Address - Country:US
Practice Address - Phone:559-795-6779
Practice Address - Fax:559-891-7542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-19
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No174200000XOther Service ProvidersMealsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4688968OtherSTATE LICENSE