Provider Demographics
NPI:1275315368
Name:HUSSEIN, HOREYA (RD)
Entity Type:Individual
Prefix:
First Name:HOREYA
Middle Name:
Last Name:HUSSEIN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1361 N HAYES AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93723-9228
Mailing Address - Country:US
Mailing Address - Phone:313-638-0247
Mailing Address - Fax:
Practice Address - Street 1:1361 N HAYES AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93723-9372
Practice Address - Country:US
Practice Address - Phone:313-638-0247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86114559133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered