Provider Demographics
NPI:1114329281
Name:ARUSSI, JENNIFER (MS, RDN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:ARUSSI
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:SCHIMSKY-ARUSSI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, RDN
Mailing Address - Street 1:22332 BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-4412
Mailing Address - Country:US
Mailing Address - Phone:310-384-5542
Mailing Address - Fax:
Practice Address - Street 1:18425 BURBANK BLVD STE 500
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6691
Practice Address - Country:US
Practice Address - Phone:818-836-8813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA840703133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1114329281OtherANTHEM