Shore, Diana K

Shore, Diana K is an individual health care provider with primary practice located at 18546 Roscoe Blvd Suite 230, Northridge CA 91324-4663. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutrition, Education, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Nutrition, Education is her primary health care specialty. Shore, Diana K can be contacted via phone (818) 886-1100.

Contact Information

Primary practice address
18546 Roscoe Blvd Suite 230 Northridge CA 91324-4663
Phone: (818) 886-1100
Fax: (818) 886-7501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Education 133NN1002X 557560 California
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 557560 California

Profile Details

NPI number 1194758664
LBN Legal business name Shore, Diana K
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194758664 NPPES
California Other 557560 STATE LICENSE

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