Individual
ALICIA M ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
1011 BALDWIN PARK BLVD, BALDWIN PARK, CA 91706-5806
(626) 506-5969
Mailing address
1011 BALDWIN PARK BLVD, BALDWIN PARK, CA 91706-5806
(626) 851-1011
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86212036
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86212036
RDN
CA
Enumeration date
09/12/2022
Last updated
05/30/2023
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