MEDICARE: NUTRITION PARTNERS IN HEALTH

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

General Provider Information

NPI Number	:	1578245460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUTRITION PARTNERS IN HEALTH

Provider Business Mailing Address
First Line	:	543 COUNTRY CLUB DR STE B516
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-0637
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	543 COUNTRY CLUB DR STE B516
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065-0637
Country	:	US
Telephone Number	:	805-796-8436
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CARLY AUSTIN
Credential	:	RD
Telephone Number	:	805-796-8436

Provider Enumeration Date	:	08/01/2023
Last Update Date	:	08/01/2023

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Directions to “NUTRITION PARTNERS IN HEALTH ” Practice Location

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