Provider Demographics
NPI:1679294094
Name:VAUGHN, CLAUDETTE (RD)
Entity type:Individual
Prefix:
First Name:CLAUDETTE
Middle Name:
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 RIDGE VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-7533
Mailing Address - Country:US
Mailing Address - Phone:401-835-5563
Mailing Address - Fax:
Practice Address - Street 1:150 RIDGE VIEW WAY
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-7533
Practice Address - Country:US
Practice Address - Phone:401-835-5563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
864665OtherCENTER FOR COMMISSION ON DIETETIC REGISTRATION