Kathleen E Duchene, RD

Individual provider Active NPI Registered Dietitian · Lakeport, CA

NPI 1104011279 · NPPES record last updated Sep 11, 2007

Key facts

NPI
1104011279
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
957895 (CA)
Practice address
5176 Hill Rd E
Lakeport, CA 95453
Phone
(707) 262-5007
Fax
(707) 262-5145
NPI assigned
Sep 11, 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
957895CAMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 957895 CA Yes

Addresses

Primary practice location

5176 Hill Rd E
Lakeport, CA 95453

Mailing address

5176 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5007

Other providers in Lakeport, CA

All providers in Lakeport, CA · Registered Dietitian in California

Sources for this page

Verify at the official NPI Registry.