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General NPI Number Information
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NPI Number | 1144136078
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Entity Type | Organization
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Legal Business Name | NOURISHED RD INC.
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Dates
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Enumeration Date | 08/20/2026
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Last Update Date | 08/20/2026
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Provider Practice Location Address
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Address Line | 3775 SIXTH AVE #605
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City | SAN DIEGO
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State | CA
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Zip | 92103-3312
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Country | US
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Telephone | 617-383-7137
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Fax | 617-613-7288
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Provider Business Mailing Address
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Address Line | 1286 UNIVERSITY AVE STE 1062
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City | SAN DIEGO
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State | CA
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Zip | 92103-3312
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Country | US
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Telephone | 617-383-7137
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Fax | 617-613-7288
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Authorized Official
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Title or Position | OWNER
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Name | MS. REBECCA SUZANNE BOKAT
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Credential | MS, RD, LDN, CEDS
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Telephone | 240-687-1703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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