Provider Demographics
NPI:1356003727
Name:ABDELHAFEEZ, FATIMA AZZAHRA (RD)
Entity Type:Individual
Prefix:
First Name:FATIMA AZZAHRA
Middle Name:
Last Name:ABDELHAFEEZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 W TOWN AND COUNTRY RD APT 1305
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4614
Mailing Address - Country:US
Mailing Address - Phone:714-860-6264
Mailing Address - Fax:
Practice Address - Street 1:200 W CENTER STREET PROMENADE STE 100A
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-3960
Practice Address - Country:US
Practice Address - Phone:657-521-6409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered