Provider Demographics
NPI:1306463534
Name:CAITLIN JOHNSON, RD, INC.
Entity type:Organization
Organization Name:CAITLIN JOHNSON, RD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:805-471-0111
Mailing Address - Street 1:110 N MCCLELLAND ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4419
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:805-335-6877
Practice Address - Street 1:110 N MCCLELLAND ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4419
Practice Address - Country:US
Practice Address - Phone:805-471-0111
Practice Address - Fax:805-335-6877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-04
Last Update Date:2020-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty