Provider Demographics
NPI:1679356414
Name:TSUI, CONNIE (RDN)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:TSUI
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15209 BERNARD CT
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-3300
Mailing Address - Country:US
Mailing Address - Phone:626-236-0759
Mailing Address - Fax:
Practice Address - Street 1:15209 BERNARD CT
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-3300
Practice Address - Country:US
Practice Address - Phone:626-236-0759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86016632133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered