Provider Demographics
NPI:1033843768
Name:RANDAZZO, ALAINA (RDN)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:
Last Name:RANDAZZO
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 S COCHRAN AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3390
Mailing Address - Country:US
Mailing Address - Phone:720-519-9546
Mailing Address - Fax:
Practice Address - Street 1:443 S COCHRAN AVE APT 203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-3390
Practice Address - Country:US
Practice Address - Phone:720-519-9546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-09
Last Update Date:2022-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86146115133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered