Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Lisa Ann Licavoli, RD

Individual provider Nutritionist · NPI 1063915080

MS. Lisa Ann Licavoli, RD is a Nutritionist in Newport Beach, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2018
Specialties on file
2
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.

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Practice location Address checks out

2289 Redlands Dr
Newport Beach, CA 92660
Phone: (949) 646-4842
Fax: (949) 646-4978
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Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence R-553289 (CA)
Nutritionist Taxonomy 133N00000X (CA)

Record details

NPI number1063915080
Entity typeIndividual (Type 1)
GenderFemale
Credentials RD
Sole proprietorYes
NPI enumeratedMarch 15, 2018
Last updated in NPPESMarch 15, 2018

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