MEDICARE: MELISSA PEARSON RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	LL004765	GA

General Provider Information

NPI Number	:	1427768126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA PEARSON RDN

Provider Business Mailing Address
First Line	:	21 CALLE KATRINA
Second Line	:
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688-5434
Country	:	US
Telephone Number	:	303-921-3172
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 CALLE KATRINA
Second Line	:
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688-5434
Country	:	US
Telephone Number	:	303-921-3172
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2022
Last Update Date	:	12/02/2022

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Directions to “ MELISSA PEARSON RDN” Practice Location

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