Individual
MRS. CANDIACE AMORA PICCOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
488 SALTY WAY, EUGENE, OR 97404-2488
(714) 318-9905
Mailing address
488 SALTY WAY, EUGENE, OR 97404-2488
(714) 318-9905
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
CDR-1106542
CA
133V00000X
Registered Dietitian
LD-D-10196307
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316377484
—
CA
Enumeration date
11/26/2013
Last updated
11/27/2019
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