Provider Demographics
NPI:1669239216
Name:GLANTZ, ASHLEY (RDN)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:GLANTZ
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 1:1595 DAKIN AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-4517
Mailing Address - Country:US
Mailing Address - Phone:805-551-1415
Mailing Address - Fax:
Practice Address - Street 1:1595 DAKIN AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-4517
Practice Address - Country:US
Practice Address - Phone:805-551-1415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered