Provider Demographics
NPI:1316021181
Name:WESTFIELD, ALFREADA H (RD)
Entity Type:Individual
Prefix:
First Name:ALFREADA
Middle Name:H
Last Name:WESTFIELD
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:ALFREADA
Other - Middle Name:H
Other - Last Name:WESTFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:PO BOX 31001 0698
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91110-0698
Mailing Address - Country:US
Mailing Address - Phone:602-263-1511
Mailing Address - Fax:602-263-1619
Practice Address - Street 1:4212 N 16TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-5319
Practice Address - Country:US
Practice Address - Phone:602-263-1511
Practice Address - Fax:602-263-1619
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
591595133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZQ43492Medicare UPIN
AZ8HD710Medicare ID - Type UnspecifiedGILA BEND PART B
AZ8EB598Medicare ID - Type UnspecifiedYAVAPAI- PART B
AZ8HD708Medicare ID - Type UnspecifiedPIMC PART B
AZ8HD709Medicare ID - Type UnspecifiedSR PART B
AZ030078Medicare Oscar/Certification