Provider Demographics
NPI:1316576366
Name:TRANG, LUCINDA (RD)
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:
Last Name:TRANG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1709 S OAKGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1221
Mailing Address - Country:US
Mailing Address - Phone:626-453-6113
Mailing Address - Fax:
Practice Address - Street 1:1709 S OAKGREEN AVE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-1221
Practice Address - Country:US
Practice Address - Phone:626-453-6113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86037882133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered