Provider Demographics
NPI:1881410314
Name:SADRI, BEHNAZ (RD)
Entity type:Individual
Prefix:
First Name:BEHNAZ
Middle Name:
Last Name:SADRI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3838 DUNN DR APT 315
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-2772
Mailing Address - Country:US
Mailing Address - Phone:310-910-2410
Mailing Address - Fax:
Practice Address - Street 1:3838 DUNN DR APT 315
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2772
Practice Address - Country:US
Practice Address - Phone:310-910-2410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-30
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86389647133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered