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General NPI Number Information
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NPI Number | 1821472127
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Entity Type | Individual
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Provider Name | MS. KANISHA MONAE NEAL
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Gender | Female
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Dates
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Enumeration Date | 07/16/2015
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 27925 ROCKWOOD AVE
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City | MORENO VALLEY
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State | CA
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Zip | 92555-5730
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Country | US
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Telephone | 951-581-4818
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Fax | 951-485-9459
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Provider Business Mailing Address
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Address Line | 27925 ROCKWOOD AVE
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City | MORENO VALLEY
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State | CA
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Zip | 92555-5730
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Country | US
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Telephone | 951-581-4818
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Fax | 951-485-9459
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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 | 133NN1002X
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Taxonomy Name | Nutrition Education 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 | 374J00000X
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Taxonomy Name | Doula
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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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