Provider Demographics
NPI:1871914143
Name:WEISS, AMRIE (RD)
Entity type:Individual
Prefix:
First Name:AMRIE
Middle Name:
Last Name:WEISS
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 1:3720 YONGE ST UNIT 10
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-1244
Mailing Address - Country:US
Mailing Address - Phone:760-452-0835
Mailing Address - Fax:
Practice Address - Street 1:3720 YONGE ST UNIT 10
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-1244
Practice Address - Country:US
Practice Address - Phone:760-452-0835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1062444133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered