Individual
BETTY LICCIARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1904 N ORANGE GROVE AVE, POMONA, CA 91767-3008
(909) 469-1823
(909) 469-1827
Mailing address
840 TOWNE CENTER DRIVE, CHAPARRAL MEDICAL GROUP INC, POMONA, CA 91767-5900
(909) 398-1550
(909) 398-1573
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
718614
—
Other
Enumeration date
05/23/2006
Last updated
09/20/2021
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