Provider Demographics
NPI:1942898655
Name:GUARINO, KIRA LUCIA
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:LUCIA
Last Name:GUARINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2252 DEL MAR RD APT 3
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1977
Mailing Address - Country:US
Mailing Address - Phone:818-281-8175
Mailing Address - Fax:
Practice Address - Street 1:2252 DEL MAR RD APT 3
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1977
Practice Address - Country:US
Practice Address - Phone:818-281-8175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty