De Fazio, Lisa
De Fazio, Lisa is an sole proprietor health care provider with primary practice located at 415 Rolling Oaks Dr Suite 210, Thousand Oaks CA 91361-1029. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. De Fazio, Lisa can be contacted via phone (805) 299-0301.Contact Information
Primary practice address
415 Rolling Oaks Dr Suite 210
Thousand Oaks CA 91361-1029
Phone: (805) 299-0301
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X | 859439 | California |
Profile Details
| NPI number | 1154597623 |
|---|---|
| LBN Legal business name | De Fazio, Lisa |
| Credentials | Registered Dietitian (RD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 5th, 2008 |
| Last updated | Jun 26th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154597623 | NPPES |
| California | Other | 859439 | DIETETIC REGISTRATION |
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