Provider Demographics
NPI:1831553684
Name:FITZPATRICK, CHRISTY (RD)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:
Other - Last Name:HELVESTINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1573 VISTA DEL MAR WAY UNIT 2
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-5986
Mailing Address - Country:US
Mailing Address - Phone:858-882-7708
Mailing Address - Fax:
Practice Address - Street 1:1573 VISTA DEL MAR WAY UNIT 2
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-5986
Practice Address - Country:US
Practice Address - Phone:858-882-7708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86016314133N00000X, 133NN1002X, 133VN1301X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1301XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA86016314OtherCDR