Individual
ANGELA M LUSTRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CN, CPT
Contact information
Practice address
5225 CANYON CREST DR, SUITE #62, RIVERSIDE, CA 92507-6301
(951) 683-0448
(951) 683-4381
Mailing address
5225 CANYON CREST DR, SUITE #62, RIVERSIDE, CA 92507-6301
(951) 683-0448
(951) 683-4381
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
02907
WA
Other
Enumeration date
06/03/2009
Last updated
06/03/2009
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