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NPI Code Detail

MEDICARE: MRS. MARINA N KALENYUK RDN

MEDICARE: MRS. MARINA N KALENYUK RDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian86153019CA

General Provider Information

NPI Number : 1629682299
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARINA N KALENYUK RDN
Provider Business Mailing Address
First Line : 4930 YUCCA WAY
Second Line :
City : NORTH HIGHLANDS
State : CA
Zip : 95660-5647
Country : US
Telephone Number : 916-476-7338
Fax Number :
Provider Business Practice Location Address
First Line : 1400 EXPO PKWY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95815-4230
Country : US
Telephone Number : 877-978-4848
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2020
Last Update Date : 09/01/2020

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