Provider Demographics
NPI:1952978306
Name:GODWIN, NATASHA (RDN)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:GODWIN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:
Other - Last Name:STUDENY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9320 EARL ST UNIT 15
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3846
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9320 EARL ST UNIT 15
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3846
Practice Address - Country:US
Practice Address - Phone:858-382-3410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86075256133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered