NPI 1669899118

Holistic Nutrition By Lisa

Organisation Medical Foods Supplier Carlsbad, CA

Practice location

Address: 2785 Roosevelt St Suite B, Carlsbad, CA 92008-1779
Phone: (760) 705-5444
Mailing address: 3446 Ravine Dr, Carlsbad, CA 92010-5557

Authorised official

Name: Lisa Blake
Title: Certified Nutrition Consultant
Phone: (760) 705-5444

Registered specialties

Medical Foods Supplier Primary

Suppliers Taxonomy 335G00000X Licence CO869296 (CA)

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Registry record

NPI: 1669899118
Entity type: Organization
NPI issued: 22 Mar 2014
Record last updated: 22 Mar 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.