Provider Demographics
NPI:1972228872
Name:TRAENDLY, KIAH (RDN)
Entity type:Individual
Prefix:
First Name:KIAH
Middle Name:
Last Name:TRAENDLY
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5937 ESTELLE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-5434
Mailing Address - Country:US
Mailing Address - Phone:908-399-1736
Mailing Address - Fax:
Practice Address - Street 1:5937 ESTELLE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-5434
Practice Address - Country:US
Practice Address - Phone:908-399-1736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
FL86062041133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered