Healthcare Provider Details

I. General information

NPI: 1639982879
Provider Name (Legal Business Name): CAROLINE CLAIRE MOREY RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1575 OLD BAYSHORE HWY STE 205
BURLINGAME CA
94010-1616
US

IV. Provider business mailing address

1575 OLD BAYSHORE HWY STE 205
BURLINGAME CA
94010-1616
US

V. Phone/Fax

Practice location:
  • Phone: 763-568-8602
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86176835
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: