Healthcare Provider Details

I. General information

NPI: 1235046053
Provider Name (Legal Business Name): NUTRITIONAL COUNCIL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15151 DARNELL DR
LAKE ELSINORE CA
92530-5504
US

IV. Provider business mailing address

15151 DARNELL DR
LAKE ELSINORE CA
92530-5504
US

V. Phone/Fax

Practice location:
  • Phone: 951-290-2960
  • Fax:
Mailing address:
  • Phone: 951-290-2960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name: JAMES BARRY MARFLEET
Title or Position: NUTRITIONIST
Credential: CNC
Phone: 714-866-9649