Individual
MARCIA LYNN EVERETT
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073-1003
(310) 268-3061
Mailing address
1329 19TH ST, C, SANTA MONICA, CA 90404-1946
(310) 428-6376
(310) 268-4944
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
894730
DIETETIC REGISTRATION
CA
Enumeration date
06/06/2006
Last updated
07/08/2007
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