Individual
JACQUELYN LISING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN
Contact information
Practice address
911 SUMMITVIEW CT, WALNUT, CA 91789
(909) 896-9103
Mailing address
911 SUMMITVIEW CT, WALNUT, CA 91789-4437
(909) 896-9103
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/14/2017
Last updated
07/21/2022
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