Provider Demographics
NPI:1306843552
Name:KASMAN, SVETLANA (RD, LAC)
Entity Type:Individual
Prefix:MS
First Name:SVETLANA
Middle Name:
Last Name:KASMAN
Suffix:
Gender:F
Credentials:RD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 S FAIRFAX AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-3541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7855 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-5344
Practice Address - Country:US
Practice Address - Phone:310-275-3835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA726996133V00000X
CA5404171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered