Provider Demographics
NPI:1053125401
Name:HARKIN, LAURA RAE (RDN)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:RAE
Last Name:HARKIN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1281 34TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-2473
Mailing Address - Country:US
Mailing Address - Phone:619-316-0918
Mailing Address - Fax:
Practice Address - Street 1:1281 34TH ST APT 3
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92102-2473
Practice Address - Country:US
Practice Address - Phone:619-316-0918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered