Provider Demographics
NPI:1619464443
Name:SONODA, VICTORIA (RDN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:SONODA
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18425 BURBANK BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2812
Mailing Address - Country:US
Mailing Address - Phone:818-342-2696
Mailing Address - Fax:
Practice Address - Street 1:18425 BURBANK BLVD STE 102
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2812
Practice Address - Country:US
Practice Address - Phone:818-342-2696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86047774133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty