Provider Demographics
NPI:1750581013
Name:ROSTAMKOLAEI, NEGIN (RDN)
Entity type:Individual
Prefix:MRS
First Name:NEGIN
Middle Name:
Last Name:ROSTAMKOLAEI
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:NEGIN
Other - Middle Name:
Other - Last Name:ROSTAMKOLAEI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:25401 CABOT RD, STE #210
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-633-5844
Mailing Address - Fax:949-305-9799
Practice Address - Street 1:25401 CABOT RD, STE #210
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-633-5844
Practice Address - Fax:949-305-9799
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1084647133V00000X
CALAC5896171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No171100000XOther Service ProvidersAcupuncturist