Healthcare Provider Details

I. General information

NPI: 1780480475
Provider Name (Legal Business Name): YOUR NUTRITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2025
Last Update Date: 02/22/2025
Certification Date: 02/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

1401 21ST ST
SACRAMENTO CA
95811-5226
US

V. Phone/Fax

Practice location:
  • Phone: 707-232-5401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: ELEANOR YANG
Title or Position: DIRECTOR OF CLINICAL OPERATIONS
Credential: RDN
Phone: 707-232-5401