Provider Demographics
NPI:1336826700
Name:ALBANEZ, AARON JAVIER (MPH, CHES)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:JAVIER
Last Name:ALBANEZ
Suffix:
Gender:M
Credentials:MPH, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:858-678-7050
Mailing Address - Fax:
Practice Address - Street 1:10140 CAMPUS POINT DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1520
Practice Address - Country:US
Practice Address - Phone:858-678-7050
Practice Address - Fax:858-678-7090
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-28
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251K00000X
CA38643133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No251K00000XAgenciesPublic Health or Welfare