Provider Demographics
NPI:1982849436
Name:GHAFFARI, ERIN NICOLE (RD)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:NICOLE
Last Name:GHAFFARI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MRS
Other - First Name:ERIN
Other - Middle Name:NICOLE
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:PO BOX 940838
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93094-0838
Mailing Address - Country:US
Mailing Address - Phone:805-433-7507
Mailing Address - Fax:
Practice Address - Street 1:2438 N PONDEROSA DR
Practice Address - Street 2:UNIT C-101
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-2369
Practice Address - Country:US
Practice Address - Phone:805-383-9727
Practice Address - Fax:805-764-0176
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL893617133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal