Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC16129 | CA |
NPI | 1225333511 |
---|---|
Provider Name | Dr. Suzette T Lanzarotta |
First Address | Newcastle, CA 95658-1294 |
Second Address | Rocklin, CA 95677-3923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2011 |
Last Update Date | 24/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC16129 | BOARD OF CHIROPRACTIC EXAMINERS (01) | CA |