Healthcare Provider Details

I. General information

NPI: 1811961808
Provider Name (Legal Business Name): MARGARET T. MCHUGH RD, CNSD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 HOSPITAL WAY
MATHER CA
95655-4200
US

IV. Provider business mailing address

1890 JUNCTION BLVD #3324
ROSEVILLE CA
95747-4983
US

V. Phone/Fax

Practice location:
  • Phone: 916-843-7000
  • Fax:
Mailing address:
  • Phone: 916-746-8750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number619735
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: