Healthcare Provider Details

I. General information

NPI: 1427489277
Provider Name (Legal Business Name): BARBARA BIRSINGER THD, MPH, RD, CEDRD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2013
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 CONCOURSE BLVD
SANTA ROSA CA
95403-8217
US

IV. Provider business mailing address

900 PINEWOOD CT
PETALUMA CA
94954-4337
US

V. Phone/Fax

Practice location:
  • Phone: 707-799-2982
  • Fax: 707-763-9380
Mailing address:
  • Phone: 707-799-2982
  • Fax: 707-763-9380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number516016
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: