Individual
JAMES VINCENT FAZZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D.
Contact information
Practice address
18030 LAMSON RD, CASTRO VALLYE, CA 94546-1313
(510) 909-7594
Mailing address
18030 LAMSON RD, CASTRO VALLYE, CA 94546-1313
(510) 909-7594
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86056770
CA
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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