MEDICARE: HEATHER HOHL

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
1	133N00000X	Nutritionist	86114476	CA
2	133NN1002X	Nutrition Education Nutritionist	86114476	CA
3	133V00000X	Registered Dietitian	86114476	CA

General Provider Information

NPI Number	:	1962167973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER HOHL

Provider Business Mailing Address
First Line	:	1401 21ST ST STE R
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95811-5226
Country	:	US
Telephone Number	:	918-407-9078
Fax Number	:

Provider Business Practice Location Address
First Line	:	21721 GRANADA AVE
Second Line	:
City	:	CUPERTINO
State	:	CA
Zip	:	95014-5934
Country	:	US
Telephone Number	:	918-407-9078
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2021
Last Update Date	:	08/21/2023

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Directions to “ HEATHER HOHL ” Practice Location

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