Provider Demographics
NPI:1326589854
Name:SCHELLENBERGER, MARIA (MS RDN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:SCHELLENBERGER
Suffix:
Gender:F
Credentials:MS RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 PURDUE AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-5135
Mailing Address - Country:US
Mailing Address - Phone:650-575-1444
Mailing Address - Fax:
Practice Address - Street 1:2470 PURDUE AVE APT 4
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-5135
Practice Address - Country:US
Practice Address - Phone:650-575-1444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered