Provider Demographics
NPI:1538438155
Name:BARBEE, MELANIE TERESA (MS RD)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:TERESA
Last Name:BARBEE
Suffix:
Gender:F
Credentials:MS RD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:T
Other - Last Name:BARRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:795 E 2ND ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-2007
Mailing Address - Country:US
Mailing Address - Phone:909-706-3779
Mailing Address - Fax:909-865-2955
Practice Address - Street 1:795 E 2ND ST
Practice Address - Street 2:SUITE 4
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91766-2007
Practice Address - Country:US
Practice Address - Phone:909-706-3779
Practice Address - Fax:909-865-2955
Is Sole Proprietor?:No
Enumeration Date:2011-12-28
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA717221133NN1002X, 133VN1005X, 133VN1006X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic