Provider Demographics
NPI:1215635818
Name:UNDERHILL, ALEXIS (RD)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:UNDERHILL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:NAZZARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:867 VISTA DEL MAR PL APT 203
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-3711
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 MOBIL AVE STE D9
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6376
Practice Address - Country:US
Practice Address - Phone:805-738-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered