Individual
LISA NICOLE LUEVANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, MPH, RD, CPH
Contact information
Practice address
510 LAKE BLVD, DAVIS, CA 95616-2854
(510) 691-0913
Mailing address
510 LAKE BLVD APT 165, DAVIS, CA 95616-2814
(510) 691-0913
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86119043
CA
Other
Enumeration date
10/02/2020
Last updated
01/31/2022
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