Basic Information
Provider Information
NPI: 1003148180
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HO
FirstName: KA-YEE
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: D.C.N, M.S, RD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WEBER
OtherFirstName: KA-YEE
OtherMiddleName: PHOEBE
OtherNamePrefix: MRS.
OtherNameSuffix:  
OtherCredential: D.C.N, M.S, RD
OtherLastNameType: 2
Mailing Information
Address1: 4601 W GROVE AVE
Address2:  
City: VISALIA
State: CA
PostalCode: 932917870
CountryCode: US
TelephoneNumber: 5598023119
FaxNumber: 5598023119
Practice Location
Address1: 4601 W GROVE AVE
Address2:  
City: VISALIA
State: CA
PostalCode: 932917870
CountryCode: US
TelephoneNumber: 5593348990
FaxNumber: 5598023119
Other Information
ProviderEnumerationDate: 02/01/2010
LastUpdateDate: 03/28/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133V00000X916023CAY Dietary & Nutritional Service ProvidersDietitian, Registered 

No ID Information.


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