Healthcare Provider Details

I. General information

NPI: 1962108324
Provider Name (Legal Business Name): HOHL NUTRITION GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21721 GRANADA AVE
CUPERTINO CA
95014-5934
US

IV. Provider business mailing address

1401 21ST ST STE R
SACRAMENTO CA
95811-5226
US

V. Phone/Fax

Practice location:
  • Phone: 918-407-9078
  • Fax: 188-887-2150
Mailing address:
  • Phone: 918-407-9078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: HEATHER HOHL
Title or Position: OWNER
Credential:
Phone: 918-407-9078