Provider Demographics
NPI:1437889599
Name:VASPRA, JULIETTE NK (MS, RDN)
Entity Type:Individual
Prefix:
First Name:JULIETTE
Middle Name:NK
Last Name:VASPRA
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 1:11513 GHIBERTI WAY
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-4083
Mailing Address - Country:US
Mailing Address - Phone:808-381-6343
Mailing Address - Fax:
Practice Address - Street 1:11513 GHIBERTI WAY
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-4083
Practice Address - Country:US
Practice Address - Phone:808-381-6343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86175243133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered