Provider Demographics
NPI:1871748392
Name:STACK-KEER, CINDY (RD)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:
Last Name:STACK-KEER
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 1:900 VETERANS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1740
Mailing Address - Country:US
Mailing Address - Phone:650-299-4993
Mailing Address - Fax:650-299-7454
Practice Address - Street 1:900 VETERANS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1740
Practice Address - Country:US
Practice Address - Phone:650-299-4993
Practice Address - Fax:650-299-7454
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA716802133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered