Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC28001 | CA |
NPI | 1518085885 |
---|---|
Provider Name | Ms. Julie Trang Le |
First Address | Sacramento, CA 95834-3846 |
Second Address | Sacramento, CA 95834-3846 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 08/07/2007 |