Provider Demographics
NPI:1902404155
Name:ZHUKOVA SHEMER, VICTORIA (RDN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:ZHUKOVA SHEMER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:SHEMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDN
Mailing Address - Street 1:39 CALYPSO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-1519
Mailing Address - Country:US
Mailing Address - Phone:626-833-7993
Mailing Address - Fax:
Practice Address - Street 1:39 CALYPSO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-1519
Practice Address - Country:US
Practice Address - Phone:626-833-7993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-10
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86078707133VN1201X, 133VN1005X, 133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Single Specialty
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Single Specialty