Provider Demographics
NPI:1699399329
Name:AZIZ, FAREEN REHANA (RD)
Entity Type:Individual
Prefix:
First Name:FAREEN
Middle Name:REHANA
Last Name:AZIZ
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 1:8590 BANTON CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-4821
Mailing Address - Country:US
Mailing Address - Phone:916-477-3877
Mailing Address - Fax:
Practice Address - Street 1:8590 BANTON CT
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-4821
Practice Address - Country:US
Practice Address - Phone:916-477-3877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered