Provider Demographics
NPI:1801769088
Name:SUSTENANCE SIMPLY CARLY ALBRECHT, RDN
Entity type:Organization
Organization Name:SUSTENANCE SIMPLY CARLY ALBRECHT, RDN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:ALBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:949-287-3197
Mailing Address - Street 1:30711 PASEO DEL NIGUEL
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-2306
Mailing Address - Country:US
Mailing Address - Phone:949-280-7274
Mailing Address - Fax:888-421-5983
Practice Address - Street 1:28202 CABOT RD STE 300
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1249
Practice Address - Country:US
Practice Address - Phone:949-287-3197
Practice Address - Fax:888-421-5983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-24
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty