Individual
LE VENA TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, IBCLC
Contact information
Practice address
2350 W SHAW AVE STE 106, FRESNO, CA 93711-3412
(559) 451-0460
Mailing address
1853 EMPRESS LN, TURLOCK, CA 95382-8707
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86329279
CA
174N00000X
Lactation Consultant (Non-RN)
L-306840
CA
Other
Enumeration date
11/03/2025
Last updated
11/03/2025
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