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General NPI Number Information
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NPI Number | 1003610403
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Entity Type | Organization
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Legal Business Name | NURTURE BY NEWBERRY
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 1720 W BALL RD # 4B1003
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City | ANAHEIM
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State | CA
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Zip | 92804-5500
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Country | US
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Telephone | 657-201-9534
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 W BALL RD STE 4B1003
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City | ANAHEIM
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State | CA
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Zip | 92804-5500
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MELINDA NEWBERRY
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Credential | RDN
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Telephone | 562-536-2571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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