MS. Lisa Ann Licavoli, R.D.
NPI #1063915080 in Newport Beach, California
Provider Information
- NPI Number
- 1063915080
- Entity Type
- Individual
- Name
- MS. Lisa Ann Licavoli, R.D.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dietitian, Registered
- Credential
- R.D.
- Enumeration Date
- Mar 15, 2018
- Last Updated
- Mar 15, 2018
Practice Location
- Address
- 2289 REDLANDS DR
- City
- Newport Beach
- State
- California
- ZIP Code
- 92660
- Phone
- (949) 646-4842
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nutritionist |
| Dietitian, Registered |
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