Individual
ILSE LEIJONANCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
21 NIETO AVE APT D, LONG BEACH, CA 90803-3347
(562) 240-3073
Mailing address
21 NIETO AVE APT D, LONG BEACH, CA 90803-3347
(562) 240-3073
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
CA
Other
Enumeration date
03/24/2023
Last updated
03/24/2023
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