Provider Demographics
NPI:1447621107
Name:NUTRITION FIT FOR LIFE, INC.
Entity type:Organization
Organization Name:NUTRITION FIT FOR LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESITA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUENROSTRO
Authorized Official - Suffix:
Authorized Official - Credentials:RND
Authorized Official - Phone:323-240-4903
Mailing Address - Street 1:28 E NEWMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-2834
Mailing Address - Country:US
Mailing Address - Phone:323-240-4903
Mailing Address - Fax:
Practice Address - Street 1:28 E NEWMAN AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-2834
Practice Address - Country:US
Practice Address - Phone:323-240-4903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA894639133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Single Specialty