Provider Demographics
NPI:1841687118
Name:LENSON, DJ (CNC)
Entity type:Individual
Prefix:MS
First Name:DJ
Middle Name:
Last Name:LENSON
Suffix:
Gender:F
Credentials:CNC
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:LENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNC
Mailing Address - Street 1:4068 MOTHER LODE DR STE K
Mailing Address - Street 2:
Mailing Address - City:SHINGLE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95682-7216
Mailing Address - Country:US
Mailing Address - Phone:530-363-0496
Mailing Address - Fax:
Practice Address - Street 1:4068 MOTHER LODE DR STE K
Practice Address - Street 2:
Practice Address - City:SHINGLE SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95682-7216
Practice Address - Country:US
Practice Address - Phone:530-363-0496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist