Individual
JANE KWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17730 LASSEN ST APT 318, NORTHRIDGE, CA 91325-4771
(626) 404-4250
Mailing address
17730 LASSEN ST APT 318, NORTHRIDGE, CA 91325-4771
(626) 404-4250
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86048210
CA
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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