Healthcare Provider Details

I. General information

NPI: 1861920720
Provider Name (Legal Business Name): NATURAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2017
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 E OLIVE AVE STE F
REDLANDS CA
92373-5281
US

IV. Provider business mailing address

10600 HIGHLAND SPRINGS AVE
CHERRY VALLEY CA
92223-5548
US

V. Phone/Fax

Practice location:
  • Phone: 909-810-0858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JAN KIELMANN
Title or Position: PRESIDENT
Credential: MS, CNS, IFMCP
Phone: 909-810-0858