Provider Demographics
NPI:1295353274
Name:AIMAQ, SAADAT (RDN)
Entity type:Individual
Prefix:MS
First Name:SAADAT
Middle Name:
Last Name:AIMAQ
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 BELLE VIEW BLVD # 3295
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307-6531
Mailing Address - Country:US
Mailing Address - Phone:703-470-6770
Mailing Address - Fax:
Practice Address - Street 1:6800 VARIEL AVE
Practice Address - Street 2:#203
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303
Practice Address - Country:US
Practice Address - Phone:703-470-6770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA984403133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered