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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154597623 NPPES
California Other 859439 DIETETIC REGISTRATION

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