Healthcare Provider Details

I. General information

NPI: 1760297493
Provider Name (Legal Business Name): H3 NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2025
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120A SUMMIT ST
CHARLOTTESVILLE VA
22903-2935
US

IV. Provider business mailing address

120A SUMMIT ST
CHARLOTTESVILLE VA
22903-2935
US

V. Phone/Fax

Practice location:
  • Phone: 916-585-4062
  • Fax: 888-322-4488
Mailing address:
  • Phone: 916-585-4062
  • Fax: 888-322-4488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133VN1101X
TaxonomyGerontological Nutrition Registered Dietitian
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: LINY LEE
Title or Position: OWNER
Credential: MS, RDN
Phone: 415-244-8853