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General NPI Number Information
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NPI Number | 1730043837
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Entity Type | Organization
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Legal Business Name | EASTERN SIERRA NUTRITION AND LACTATION LLC
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 187 MAY ST
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City | BISHOP
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State | CA
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Zip | 93514-2709
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Country | US
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Telephone | 760-920-6574
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Fax | 760-582-4559
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Provider Business Mailing Address
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Address Line | 425 CLARKE ST UNIT B
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City | BISHOP
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State | CA
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Zip | 93514-3528
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Country | US
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Telephone | 760-920-6574
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Fax | 760-582-4559
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Authorized Official
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Title or Position | OWNER
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Name | GRACE VOORHEIS
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Credential | RD, CSP, IBCLC
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Telephone | 909-210-1901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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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 | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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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 | 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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