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General NPI Number Information
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NPI Number | 1518144161
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Entity Type | Individual
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Provider Name | CINDY ANN DAVERSA M.S., R.D., C.D.E.
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Gender | Female
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Dates
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Enumeration Date | 01/25/2008
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 9834 GENESEE AVE STE 300
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City | LA JOLLA
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State | CA
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Zip | 92037-1215
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Country | US
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Telephone | 858-678-7071
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Fax |
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Provider Business Mailing Address
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Address Line | 10790 RANCHO BERNARDO RD
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City | SAN DIEGO
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State | CA
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Zip | 92127-5705
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Country | US
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Telephone | 858-678-7050
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | R10602
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License Number State | CA
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