Individual
HEATHER FITZGERALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
11633 SAN VICENTE BLVD STE 300, LOS ANGELES, CA 90049-6512
(213) 712-6834
(310) 861-1458
Mailing address
625 MIDVALE AVE APT 5, LOS ANGELES, CA 90024-2334
(213) 712-6834
(310) 861-1458
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
873919
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
873919
REGISTRATION NUMBER
CA
Enumeration date
09/24/2019
Last updated
09/24/2019
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