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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

MARY JEANNE DER AVEDISSIAN, M.S., R.D.
626 MYRTLE ST
GLENDALE, CA91203-1612
 Phone: 818-240-4328
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for MARY JEANNE DER AVEDISSIAN · (Female)

NPI # 1003033531
Status Active
Credentials M.S., R.D.
Entity Individual
Enumeration date 04/19/2007
Last updated 06/18/2013 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 590756
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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