NPI 1043265622

Betty Licciardo, RD

Practitioner Registered Dietitian Pomona, CA

Practice location

Address: 1904 N Orange Grove Ave, Pomona, CA 91767-3008
Phone: (909) 469-1823
Fax: (909) 469-1827
Mailing address: 840 Towne Center Drive Chaparral Medical Group INC, Pomona, CA 91767-5900

Registered specialties

Registered Dietitian Primary

Dietary & Nutritional Service Providers Taxonomy 133V00000X Licence 718614

Other Dietitian, Registered providers in California →

Registry record

NPI: 1043265622
Entity type: Individual
Sex (as registered): Female
NPI issued: 23 May 2006
Record last updated: 20 Sep 2021

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.