Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | 31950 | CA |
NPI | 1487911384 |
---|---|
Provider Name | Joni Laraine Stier |
First Address | Newport Beach, CA 92663-4218 |
Second Address | Newport Beach, CA 92663-4218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2012 |
Last Update Date | 19/12/2013 |