Nancy Schill Bloom, R.D.

Individual provider Active NPI Registered Dietitian · Larkspur, CA

NPI 1033325907 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1033325907
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
DT02906 (TX)
Practice address
2 Bon Air Rd
Suite 100
Larkspur, CA 94939-1141
Phone
(415) 927-0666
Fax
(415) 927-6168
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DT02906TXMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DT02906 TX Yes

Addresses

Primary practice location

2 Bon Air Rd
Suite 100
Larkspur, CA 94939-1141

Mailing address

2 Del Casa Dr
Mill Valley, CA 94941-1322
Phone (415) 389-6422

Other identifiers

IdentifierTypeStateIssuer
00572874OtherCADIETETIC REGISTRATION #

Other providers in Larkspur, CA

All providers in Larkspur, CA · Registered Dietitian in California

Sources for this page

Verify at the official NPI Registry.