Provider Demographics
NPI:1982941357
Name:TAWNEY, WHITNEY ZENNA (RD, CEDRD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ZENNA
Last Name:TAWNEY
Suffix:
Gender:F
Credentials:RD, CEDRD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 COSENZA PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91701-9244
Mailing Address - Country:US
Mailing Address - Phone:909-263-5304
Mailing Address - Fax:
Practice Address - Street 1:219 N INDIAN HILL BLVD STE 201
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4644
Practice Address - Country:US
Practice Address - Phone:909-263-5304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-05
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1007802133V00000X
CA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty