Individual
COLLEEN WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1218 CALLE AURORA, CAMARILLO, CA 93010-8438
(805) 501-5381
Mailing address
1218 CALLE AURORA, CAMARILLO, CA 93010-8438
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1048456
CA
Other
Enumeration date
02/28/2026
Last updated
04/05/2026
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