MEDICARE: MRS. ASTRID T. FERENCY M.S.R.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133VN1005X	Renal Nutrition Registered Dietitian

General Provider Information

NPI Number	:	1043432024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASTRID T. FERENCY M.S.R.D.

Provider Business Mailing Address
First Line	:	1561 HILL DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1437
Country	:	US
Telephone Number	:	323-478-9553
Fax Number	:

Provider Business Practice Location Address
First Line	:	17815 VENTURA BLVD STE 100
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-3600
Country	:	US
Telephone Number	:	818-757-4520
Fax Number	:	818-757-1043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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