Individual
JOAN BOOTHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1234 FOOTHILL BLVD, LA VERNE, CA 91750-3329
(909) 596-4879
(909) 596-9199
Mailing address
1234 FOOTHILL BLVD, LA VERNE, CA 91750-3329
(909) 596-4879
(909) 596-9199
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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