Traci Prendergast, FNLP, CNFC
Individual provider Active NPI Nutrition Education Nutritionist · San Geronimo, CA
NPI 1447086632 · NPPES record last updated Sep 12, 2024
Key facts
- NPI
- 1447086632
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nutrition Education Nutritionist 133NN1002X
- Practice address
- 100 Creamery Rd # 372
San Geronimo, CA 94963-3634 - Phone
- (415) 341-6581
- NPI assigned
- Sep 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | Yes |
Addresses
Primary practice location
100 Creamery Rd # 372
San Geronimo, CA 94963-3634
Mailing address
PO Box 372
San Geronimo, CA 94963-0372
Phone (415) 341-6581
Other providers in San Geronimo, CA
- Coastal Health Alliance
- Carolyn Gereau
- Margaret M Gruenke
- Marin Youth Therapy Inc.
- Monroe Operations, LLC
- Somatic Family Therapy of Marin, Inc
- Keri Anne Syndulko
- Gretchen Zimmermann
All providers in San Geronimo, CA · Nutrition Education Nutritionist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.