Jardack, Patricia Miranda

Jardack, Patricia Miranda is an sole proprietor health care provider with primary practice located at 10833 Le Conte Ave 37-075 Chs, Los Angeles CA 90095-1697. She recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutrition, Metabolic, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Dietitian, Registered is her primary health care specialty. Jardack, Patricia Miranda can be contacted via phone (310) 825-5768.

Contact Information

Primary practice address
10833 Le Conte Ave 37-075 Chs Los Angeles CA 90095-1697
Phone: (310) 825-5768
Fax: (310) 267-1054
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Metabolic 133VN1006X 872564 California
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 872564 California

Profile Details

NPI number 1215406269
LBN Legal business name Jardack, Patricia Miranda
Credentials RDN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 20th, 2018
Last updated Nov 20th, 2018 - about 8 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 1215406269 NPPES
Other 872564 RDN REGISTRATION

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