Individual
MRS. CERISSA ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH, RDN
Contact information
Practice address
1074 VIEJO HILLS DR, LAKE FOREST, CA 92610-3029
(863) 558-5218
Mailing address
1074 VIEJO HILLS DR, LAKE FOREST, CA 92610-3029
(863) 558-5218
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
951354
CA
133VN1005X
Renal Nutrition Registered Dietitian
951354
CA
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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