Provider Demographics
NPI:1689328338
Name:NAGHASH MAHERI, MARYAM (RD)
Entity Type:Individual
Prefix:
First Name:MARYAM
Middle Name:
Last Name:NAGHASH MAHERI
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 1:2355 STANWELL CIR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4806
Mailing Address - Country:US
Mailing Address - Phone:925-646-5145
Mailing Address - Fax:
Practice Address - Street 1:2355 STANWELL CIR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4806
Practice Address - Country:US
Practice Address - Phone:925-646-5145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86091072133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered