MEDICARE: BARIATRIC MEAL PREP LLC

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	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian

General Provider Information

NPI Number	:	1922959394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARIATRIC MEAL PREP LLC

Provider Business Mailing Address
First Line	:	23270 HOGSBACK RD
Second Line	:
City	:	RED BLUFF
State	:	CA
Zip	:	96080-9000
Country	:	US
Telephone Number	:	530-570-2361
Fax Number	:

Provider Business Practice Location Address
First Line	:	23270 HOGSBACK RD
Second Line	:
City	:	RED BLUFF
State	:	CA
Zip	:	96080-9000
Country	:	US
Telephone Number	:	530-570-2361
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED DIETITIAN & OWNER
Name	:	MRS. KRISTIN WILLARD
Credential	:	RDN
Telephone Number	:	530-570-2361

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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