| NPI | 1104518620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARVETTE EDMONDS Dietitian/Owner 949-409-1508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2024-03-13 |