Individual
LORIE BRENDECKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
922 BASILONE DR, RIVERSIDE, CA 92506-4900
(951) 776-7403
Mailing address
922 BASILONE DR, RIVERSIDE, CA 92506-4900
(951) 776-7403
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1099838
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1099838
REGISTERED DIETITIAN
CA
Enumeration date
03/29/2021
Last updated
03/29/2021
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