Individual
MS. LAURIE J WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,RD,CDE
Contact information
Practice address
9500 STOCKDALE HWY STE 203, BAKERSFIELD, CA 93311-3621
(661) 587-8110
(661) 587-8220
Mailing address
3400 DATA DR, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/05/2007
Last updated
09/14/2022
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