Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC 23696 | CA |
NPI | 1003048398 |
---|---|
Provider Name | Dr. Jeanette S. Steputis Ryan |
First Address | Pacific Palisades, CA 90272-3810 |
Second Address | Santa Monica, CA 90404-2756 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2009 |
Last Update Date | 20/08/2009 |