Healthcare Provider Details

I. General information

NPI: 1982559639
Provider Name (Legal Business Name): SIERRA BROOK SIEMERS RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2776 PACIFIC AVE
LONG BEACH CA
90806-2613
US

IV. Provider business mailing address

8102 MARSEILLE DR
HUNTINGTON BEACH CA
92647-6018
US

V. Phone/Fax

Practice location:
  • Phone: 562-997-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number86290484
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: