Individual
CASEY NOELLE BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
32 CALLE PROSPERO, SAN CLEMENTE, CA 92673-3258
(949) 292-9152
Mailing address
32 CALLE PROSPERO, SAN CLEMENTE, CA 92673-3258
(949) 292-9152
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86079397
CA
Other
Enumeration date
02/21/2020
Last updated
02/21/2020
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