Provider Demographics
NPI:1043432024
Name:FERENCY, ASTRID T (MSRD)
Entity Type:Individual
Prefix:MRS
First Name:ASTRID
Middle Name:T
Last Name:FERENCY
Suffix:
Gender:F
Credentials:MSRD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1561 HILL DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1437
Mailing Address - Country:US
Mailing Address - Phone:323-478-9553
Mailing Address - Fax:
Practice Address - Street 1:17815 VENTURA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3600
Practice Address - Country:US
Practice Address - Phone:818-757-4520
Practice Address - Fax:818-757-1043
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal