Individual provider · Type 1 NPI

Crystal Lailla Wallstrom, MS, RDN

Registered Dietitian · Los Angeles, CA

NPI number 1487969960 Active

Practice location

752 Portola Ter
Los Angeles, CA 90042-5018

Call (909) 936-5088 Map

Specialties and licenses

TaxonomyCodeLicense
Registered Dietitian Primary 133V00000XNone listed

Registered Dietitian: A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the…

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About NPI 1487969960

Crystal Lailla Wallstrom, MS, RDN's National Provider Identifier is 1487969960, issued on Aug 9, 2010. The primary taxonomy on file is Registered Dietitian (133V00000X), and the practice location is in Los Angeles, CA. The record was last updated on Jun 29, 2026.