Provider Demographics
NPI:1275984619
Name:SAFFARINIA, SORAYA (BS, NC)
Entity Type:Individual
Prefix:
First Name:SORAYA
Middle Name:
Last Name:SAFFARINIA
Suffix:
Gender:F
Credentials:BS, NC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 PETALUMA AVE
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-4224
Mailing Address - Country:US
Mailing Address - Phone:707-823-7602
Mailing Address - Fax:
Practice Address - Street 1:14 LOMA LINDA DR
Practice Address - Street 2:
Practice Address - City:COTATI
Practice Address - State:CA
Practice Address - Zip Code:94931-5200
Practice Address - Country:US
Practice Address - Phone:707-823-7602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education