Provider Demographics
NPI:1699051904
Name:CROUCH, WHITNEY (RDN)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:CROUCH
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31939 RICHGROVE CT
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4125
Mailing Address - Country:US
Mailing Address - Phone:818-404-8022
Mailing Address - Fax:
Practice Address - Street 1:31939 RICHGROVE CT
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4125
Practice Address - Country:US
Practice Address - Phone:818-404-8022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA999395133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered