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General NPI Number Information
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NPI Number | 1568015436
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Entity Type | Individual
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Provider Name | RON KUSEK NSCA-CPT, CTNC, FAS
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Gender | Male
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Dates
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Enumeration Date | 07/19/2019
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 27340 ROCK ROSE LN APT 101
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City | CANYON COUNTRY
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State | CA
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Zip | 91387-5155
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Country | US
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Telephone | 661-524-6160
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Fax |
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Provider Business Mailing Address
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Address Line | 27340 ROCK ROSE LN APT 101
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City | CANYON COUNTRY
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State | CA
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Zip | 91387-5155
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Country | US
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Telephone | 661-524-6160
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Fax | 661-418-5916
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 89258
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License Number State | CA
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