Provider Demographics
NPI:1720605579
Name:HEVER, JULIEANNA (MS, RD)
Entity Type:Individual
Prefix:
First Name:JULIEANNA
Middle Name:
Last Name:HEVER
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9304
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91372-9304
Mailing Address - Country:US
Mailing Address - Phone:310-502-0690
Mailing Address - Fax:
Practice Address - Street 1:4736 PARK GRANADA UNIT 235
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-1536
Practice Address - Country:US
Practice Address - Phone:310-502-0690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-28
Last Update Date:2020-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA897591133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty