Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | DC27427 | CA |
NPI | 1164515086 |
---|---|
Provider Name | Mrs. Cecilia B Euredjian |
First Address | Castaic, CA 91384-3059 |
Second Address | Granada Hills, CA 91344-6373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 24/03/2020 |