Provider Demographics
NPI:1740910165
Name:ALANIZ, BERNADINE MARY
Entity type:Individual
Prefix:
First Name:BERNADINE
Middle Name:MARY
Last Name:ALANIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5139 WHITE OAK AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-2432
Mailing Address - Country:US
Mailing Address - Phone:858-335-9240
Mailing Address - Fax:
Practice Address - Street 1:5139 WHITE OAK AVE
Practice Address - Street 2:APARTMENT 1
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316
Practice Address - Country:US
Practice Address - Phone:858-335-9240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist