Healthcare Provider Details
I. General information
NPI: 1548127947
Provider Name (Legal Business Name): RITUAL NUTRITION INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1918 BONITA AVE # 208
BERKELEY CA
94704-1014
US
IV. Provider business mailing address
1918 BONITA AVE # 208
BERKELEY CA
94704-1014
US
V. Phone/Fax
- Phone: 510-671-1454
- Fax:
- Phone: 510-671-1454
- Fax: 707-596-7997
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ELLEN
MARIE
ALONSO STREET
Title or Position: CEO/FOUNDER
Credential: MS, RD
Phone: 514-671-1454