Individual
KATHRYN WISTUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2659 STATE ST STE 100, CARLSBAD, CA 92008-1627
(619) 350-6290
Mailing address
3214 N BLAIR AVE, ROYAL OAK, MI 48073-3560
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86298751
MI
Other
Enumeration date
12/16/2025
Last updated
12/16/2025
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