Provider Demographics
NPI:1437641222
Name:HARUTIAN, ZARA (REGISTERED DIETITIAN)
Entity Type:Individual
Prefix:
First Name:ZARA
Middle Name:
Last Name:HARUTIAN
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10244 HORSEHAVEN ST
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-3750
Mailing Address - Country:US
Mailing Address - Phone:818-568-5296
Mailing Address - Fax:
Practice Address - Street 1:10244 HORSEHAVEN ST
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-3750
Practice Address - Country:US
Practice Address - Phone:818-568-5296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86063484133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered