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Individual

MRS. AMY L. ELLSWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
524 12TH STREET, HUNTINGTON BEACH, CA 92648-4034
(714) 376-4542
Mailing address
PO BOX 5281, HUNTINGTON BEACH, CA 92615-5281
(714) 376-4542

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1035075

Other

Enumeration date
03/29/2012
Last updated
03/29/2012
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