Healthcare Provider Details

I. General information

NPI: 1760780944
Provider Name (Legal Business Name): APRIL N. HACKERT MS, RDN, LPN,CEDRD-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: APRIL N. WINSLOW MS, RD

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 MISSION ST
SANTA CRUZ CA
95060-3614
US

IV. Provider business mailing address

PO BOX 9531
SOUTH LAKE TAHOE CA
96158
US

V. Phone/Fax

Practice location:
  • Phone: 831-204-8344
  • Fax: 408-625-6248
Mailing address:
  • Phone: 831-204-8344
  • Fax: 408-625-6248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number915311
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number915311
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: