Healthcare Provider Details

I. General information

NPI: 1467980847
Provider Name (Legal Business Name): LINDA LEE LAMAS RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDA LEE HALTER RDN

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 VIEWTOP CIR
CORONA CA
92881-8336
US

IV. Provider business mailing address

855 VIEWTOP CIR
CORONA CA
92881-8336
US

V. Phone/Fax

Practice location:
  • Phone: 323-559-9897
  • Fax:
Mailing address:
  • Phone: 323-559-9897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number835491
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number835491
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number835491
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: