Provider Demographics
NPI:1790470466
Name:KAZANDJIAN, ARIANA I (NUTRITIONIST)
Entity Type:Individual
Prefix:MRS
First Name:ARIANA
Middle Name:
Last Name:KAZANDJIAN
Suffix:I
Gender:F
Credentials:NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 PALMS BLVD
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-3525
Mailing Address - Country:US
Mailing Address - Phone:310-745-4115
Mailing Address - Fax:
Practice Address - Street 1:1100 PALMS BLVD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-3525
Practice Address - Country:US
Practice Address - Phone:310-745-4115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist