Individual
DEBBIE VONGVIWAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN
Contact information
Practice address
2212 E 4TH ST STE 301, SANTA ANA, CA 92705
(714) 628-3242
Mailing address
1095 IRVINE BLVD, TUSTIN, CA 92780-3526
(714) 505-7110
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86062680
CA
Other
Enumeration date
05/01/2019
Last updated
08/19/2022
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