Individual
LAURIE SULLENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
222 W 39TH AVE, SAN MATEO, CA 94403-4364
(650) 573-3580
Mailing address
16 LOS FLORES AVE, SOUTH SAN FRANCISCO, CA 94080-2236
(415) 217-9253
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
929938
CA
Other
Enumeration date
06/16/2016
Last updated
06/16/2016
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