Provider Demographics
NPI:1841630670
Name:ANDERSON, POPPY (RD)
Entity type:Individual
Prefix:
First Name:POPPY
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:POPPY
Other - Middle Name:
Other - Last Name:MAJOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7315 STARWARD DR APT 57
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-1861
Mailing Address - Country:US
Mailing Address - Phone:925-339-2467
Mailing Address - Fax:
Practice Address - Street 1:7315 STARWARD DR APT 57
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-1861
Practice Address - Country:US
Practice Address - Phone:925-339-2467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA952195133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered