Provider Demographics
NPI:1487076667
Name:DENNEY, NANNETTE SUZANNE (RD)
Entity type:Individual
Prefix:
First Name:NANNETTE
Middle Name:SUZANNE
Last Name:DENNEY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 SAGETREE LN
Mailing Address - Street 2:
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-2249
Mailing Address - Country:US
Mailing Address - Phone:951-850-3942
Mailing Address - Fax:
Practice Address - Street 1:2710 SAGETREE LN
Practice Address - Street 2:
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-2249
Practice Address - Country:US
Practice Address - Phone:951-850-3942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA718839133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered