Individual
MISS AGATA J JACNIACKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
6041 CADILLAC AVE, LOS ANGELES, CA 90034-1702
(323) 857-2000
Mailing address
27037 BIG RAPIDS LOOP, 1, VALENCIA, CA 91354-2642
(661) 476-9241
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1035579
CA
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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