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Individual

CHRISTINE MARIE LEWALLEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.D.

Contact information

Practice address
2233 GRAND CANAL BLVD STE 106, STOCKTON, CA 95207-6657
(209) 483-7647
Mailing address
3143 SEA GULL LN, STOCKTON, CA 95219-4604
(209) 483-7647

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
876533
CA

Other

Enumeration date
11/13/2006
Last updated
03/09/2018
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