Provider Demographics
NPI:1154187862
Name:O'DONNELL, AUBREY BROPHY (RD, CSR)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:BROPHY
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:RD, CSR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3559 POE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-1806
Mailing Address - Country:US
Mailing Address - Phone:951-830-3976
Mailing Address - Fax:
Practice Address - Street 1:3559 POE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-1806
Practice Address - Country:US
Practice Address - Phone:951-830-3976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal