Provider Demographics
NPI:1225845043
Name:CAVALLARI, KRISTINA (RHN)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:CAVALLARI
Suffix:
Gender:F
Credentials:RHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 HUNTINGDON CRESCENT
Mailing Address - Street 2:
Mailing Address - City:NORTH VANCOUVER
Mailing Address - State:BC
Mailing Address - Zip Code:V7G 1M1
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:715 HUNTINGDON CRESCENT
Practice Address - Street 2:
Practice Address - City:NORTH VANCOUVER
Practice Address - State:BC
Practice Address - Zip Code:V7G 1M1
Practice Address - Country:CA
Practice Address - Phone:604-364-3086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZN616914133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education