Provider Demographics
NPI:1942064860
Name:GEFFREY, SHIROMI P (MS, RDN)
Entity Type:Individual
Prefix:
First Name:SHIROMI
Middle Name:P
Last Name:GEFFREY
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4050 KATELLA AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3463
Mailing Address - Country:US
Mailing Address - Phone:562-493-0242
Mailing Address - Fax:
Practice Address - Street 1:4050 KATELLA AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3463
Practice Address - Country:US
Practice Address - Phone:562-493-0242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty