Healthcare Provider Details

I. General information

NPI: 1609794007
Provider Name (Legal Business Name): NOURISH KINDLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8551 CYPRESS PT
BUENA PARK CA
90621-1610
US

IV. Provider business mailing address

8551 CYPRESS PT
BUENA PARK CA
90621-1610
US

V. Phone/Fax

Practice location:
  • Phone: 714-351-0608
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MADISON MURPHY
Title or Position: REGISTERED DIETITIAN
Credential: MS, RD
Phone: 714-351-0608