Healthcare Provider Details

I. General information

NPI: 1225992076
Provider Name (Legal Business Name): EAT BEYOND LABELS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3079 HARRISON AVE STE 12
SOUTH LAKE TAHOE CA
96150-7978
US

IV. Provider business mailing address

3079 HARRISON AVE STE 12 UNIT 131
SOUTH LAKE TAHOE CA
96150-7978
US

V. Phone/Fax

Practice location:
  • Phone: 530-314-8870
  • Fax: 530-314-8972
Mailing address:
  • Phone: 530-314-8870
  • Fax: 530-314-8972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: CHRISTY WALOWIT
Title or Position: OWNER
Credential: RD
Phone: 530-314-8870