Provider Demographics
NPI:1053846949
Name:WEIS, ALISON (MS, RD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:WEIS
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:TEDROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS RD
Mailing Address - Street 1:7039 PAINTER AVE APT B
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-6659
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7039 PAINTER AVE APT B
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-6659
Practice Address - Country:US
Practice Address - Phone:760-822-3589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA001086991133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered