Individual
MARY SEIERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDE
Contact information
Practice address
3851 KATELLA AVE STE 275, LOS ALAMITOS, CA 90720-3377
(562) 296-5528
(562) 296-8506
Mailing address
15464 GOLDENWEST ST, WESTMINSTER, CA 92683-6149
(714) 891-9008
(714) 893-2239
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
—
—
163WD0400X
Diabetes Educator Registered Nurse
711000
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
711000
STATE LICENSE #
CA
Enumeration date
04/09/2007
Last updated
12/28/2023
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