Provider Demographics
NPI:1346563475
Name:DOEVE, ANITA BASU (RD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:BASU
Last Name:DOEVE
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:MRS
Other - First Name:ANITA
Other - Middle Name:BASU
Other - Last Name:DOEVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD, CDE
Mailing Address - Street 1:1325 N ROSE DR STE 210
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3800
Mailing Address - Country:US
Mailing Address - Phone:714-203-1799
Mailing Address - Fax:714-203-1716
Practice Address - Street 1:16671 YORBA LINDA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-2025
Practice Address - Country:US
Practice Address - Phone:714-577-9090
Practice Address - Fax:714-203-1716
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA914541133VN1005X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Multi-Specialty