Provider Demographics
NPI:1437880457
Name:KAWAMURA, DEBBIE K (RD)
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:K
Last Name:KAWAMURA
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 1:5161 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LA CANADA FLINTRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91011-2453
Mailing Address - Country:US
Mailing Address - Phone:818-790-7999
Mailing Address - Fax:
Practice Address - Street 1:5161 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:LA CANADA FLINTRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91011-2453
Practice Address - Country:US
Practice Address - Phone:818-790-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA708241133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered