Individual
AMBER JAMES WAGSTAFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
23320 CANYON LAKE DR N, CANYON LAKE, CA 92587-8007
(714) 809-2993
Mailing address
23320 CANYON LAKE DR N, CANYON LAKE, CA 92587-8007
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
CA
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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