Organization
CALIFORNIA CLINICAL NUTRITION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE JIN (OWNER)
(951) 691-0933
Entity
Organization
Contact information
Practice address
1309 W MISSION BLVD UNIT 50, ONTARIO, CA 91762-6845
(951) 691-0933
Mailing address
19207 AMBER VALLEY DR, WALNUT, CA 91789-4505
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/24/2026
Last updated
03/24/2026
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