Individual
KACY DYAN GROSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., R.D.
Contact information
Practice address
1314 WESTWOOD BLVD STE 201, LOS ANGELES, CA 90024-4928
(805) 796-0085
Mailing address
6371 SMOKE TREE AVE, OAK PARK, CA 91377-1249
(805) 796-0085
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1020536
CA
Other
Enumeration date
07/21/2016
Last updated
07/21/2016
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