Provider Demographics
NPI:1902431596
Name:BOYD, STEPHANIE MORGAN (RD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MORGAN
Last Name:BOYD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:MORGAN
Other - Last Name:COWARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:1675 GREEN ST APT 7
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-5015
Mailing Address - Country:US
Mailing Address - Phone:916-838-1925
Mailing Address - Fax:
Practice Address - Street 1:1499 WEBSTER ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3705
Practice Address - Country:US
Practice Address - Phone:415-928-9003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-04
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86062322133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered