Individual
AMY LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 ALAMEDA PADRE SERRA, SANTA BARBARA, CA 93103-2806
(916) 402-9119
Mailing address
220 ALAMEDA PADRE SERRA, SANTA BARBARA, CA 93103-2806
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86081997
CA
Other
Enumeration date
05/23/2017
Last updated
05/23/2017
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