Provider Demographics
NPI:1285309302
Name:MCCURDY, LAURA ANN (RD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:MCCURDY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:ANN MCCURDY
Other - Last Name:GREGORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:100 CALIFORNIA DRIVE
Mailing Address - Street 2:FOOD AND NUTRITION SERVICES
Mailing Address - City:YOUNTVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94599-1411
Mailing Address - Country:US
Mailing Address - Phone:707-944-3626
Mailing Address - Fax:
Practice Address - Street 1:100 CALIFORNIA DRIVE
Practice Address - Street 2:FOOD AND NUTRITION SERVICES
Practice Address - City:YOUNTVILLE
Practice Address - State:CA
Practice Address - Zip Code:94599-1411
Practice Address - Country:US
Practice Address - Phone:707-944-3626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000872473133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered