Healthcare Provider Details

I. General information

NPI: 1902089907
Provider Name (Legal Business Name): LISA SINGER C.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44319 SILVER CANYON LN
PALM DESERT CA
92260-3078
US

IV. Provider business mailing address

44319 SILVER CANYON LN
PALM DESERT CA
92260-3078
US

V. Phone/Fax

Practice location:
  • Phone: 760-238-8895
  • Fax:
Mailing address:
  • Phone: 760-238-8895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number000889
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: