Provider Demographics
NPI:1487194130
Name:DOSHI, LUCIA MARION (RD/RDN, MPH)
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:MARION
Last Name:DOSHI
Suffix:
Gender:F
Credentials:RD/RDN, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 CONIFER LN
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-6853
Mailing Address - Country:US
Mailing Address - Phone:714-599-3898
Mailing Address - Fax:
Practice Address - Street 1:2301 CONIFER LN
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-6853
Practice Address - Country:US
Practice Address - Phone:714-599-3898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00991816133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered