Provider Demographics
NPI:1841628625
Name:VALDES, KATHARINE (MS, RD, CSSD)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:VALDES
Suffix:
Gender:F
Credentials:MS, RD, CSSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3283 ALEGRE LN
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-1501
Mailing Address - Country:US
Mailing Address - Phone:818-903-6284
Mailing Address - Fax:
Practice Address - Street 1:3283 ALEGRE LN
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-1501
Practice Address - Country:US
Practice Address - Phone:818-903-6284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric