Provider Demographics
NPI:1740815471
Name:RIGDEN, MIA (MS)
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:
Last Name:RIGDEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 NAVY ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-5638
Mailing Address - Country:US
Mailing Address - Phone:415-306-1551
Mailing Address - Fax:
Practice Address - Street 1:807 NAVY ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-5638
Practice Address - Country:US
Practice Address - Phone:415-306-1551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist