Individual
ANGELA LISTERUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2573 HALALU ST, KOLOA, HI 96756
(714) 727-7943
Mailing address
PO BOX 1821, KOLOA, HI 96756-1821
(714) 727-7943
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86111104
CA
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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