Provider Demographics
NPI:1891119616
Name:SAFE HASHEMI, SOHEYLA (RD)
Entity Type:Individual
Prefix:
First Name:SOHEYLA
Middle Name:
Last Name:SAFE HASHEMI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:SOHEYLA
Other - Middle Name:
Other - Last Name:SEYFHASHEMI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:24585 TOWN CENTER DR
Mailing Address - Street 2:4403
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1366
Mailing Address - Country:US
Mailing Address - Phone:510-967-4489
Mailing Address - Fax:
Practice Address - Street 1:24585 TOWN CENTER DR
Practice Address - Street 2:4403
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1366
Practice Address - Country:US
Practice Address - Phone:510-967-4489
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
132700000X, 133N00000X, 133NN1002X, 133VN1004X, 133VN1005X, 133VN1006X
CA1069997133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No132700000XDietary & Nutritional Service ProvidersDietary Manager
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic