Individual
ELIZABETH BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH, RDN
Contact information
Practice address
16301 EAGLE LN, HUNTINGTON BEACH, CA 92649-2715
(562) 619-6272
Mailing address
16301 EAGLE LN, HUNTINGTON BEACH, CA 92649-2715
(562) 619-6272
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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