Individual
ASTRIN P DAMAYANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
10940 TRINITY PKWY STE C305, STOCKTON, CA 95219-7234
(209) 715-5858
Mailing address
10940 TRINITY PKWY STE C305, STOCKTON, CA 95219-7234
(209) 715-5858
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
961513
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
961513
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
06/25/2008
Last updated
04/12/2021
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