Provider Demographics
NPI:1043190317
Name:CHINN-DAVIS, DEBBIE (MAS, MS, RD)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:CHINN-DAVIS
Suffix:
Gender:F
Credentials:MAS, MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 DOUGLAS BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3868
Mailing Address - Country:US
Mailing Address - Phone:916-774-8885
Mailing Address - Fax:916-503-6841
Practice Address - Street 1:3100 DOUGLAS BLVD STE 204
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3868
Practice Address - Country:US
Practice Address - Phone:916-774-8885
Practice Address - Fax:916-503-6841
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty