Individual
MRS. JACQUELINE ROLDAN DE LOS REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, CLE
Contact information
Practice address
16120 E BADILLO ST, COVINA, CA 91722-4033
(626) 856-8811
Mailing address
16120 E BADILLO ST, COVINA, CA 91722-4033
(626) 856-8811
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
824190
IL
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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