Provider Demographics
NPI:1720897531
Name:COUGHLER, ALYSHA M (RD)
Entity type:Individual
Prefix:
First Name:ALYSHA
Middle Name:M
Last Name:COUGHLER
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 1:185 CHANNEL ST APT 430
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-1722
Mailing Address - Country:US
Mailing Address - Phone:628-220-1541
Mailing Address - Fax:
Practice Address - Street 1:185 CHANNEL ST APT 430
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-1722
Practice Address - Country:US
Practice Address - Phone:628-220-1541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86390385133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered