Provider Demographics
NPI:1730466442
Name:REGUEIRO-NUNEZ, LIZZETTE A (MS, RD, CLE)
Entity Type:Individual
Prefix:MRS
First Name:LIZZETTE
Middle Name:A
Last Name:REGUEIRO-NUNEZ
Suffix:
Gender:F
Credentials:MS, RD, CLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 N ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-3608
Mailing Address - Country:US
Mailing Address - Phone:818-472-6244
Mailing Address - Fax:
Practice Address - Street 1:237 N ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-3608
Practice Address - Country:US
Practice Address - Phone:818-472-6244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered