Provider Demographics
NPI:1427125988
Name:POLLETT, LENEA MARIE (RD)
Entity type:Individual
Prefix:
First Name:LENEA
Middle Name:MARIE
Last Name:POLLETT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80655
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-0655
Mailing Address - Country:US
Mailing Address - Phone:949-274-5691
Mailing Address - Fax:904-212-7859
Practice Address - Street 1:31996 VIA COYOTE
Practice Address - Street 2:
Practice Address - City:COTO DE CAZA
Practice Address - State:CA
Practice Address - Zip Code:92679-4109
Practice Address - Country:US
Practice Address - Phone:949-274-5691
Practice Address - Fax:904-212-7859
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA717599133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered