MEDICARE: ALEJANDRA PEREZ ARELLANO RDN

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	133V00000X	Registered Dietitian	86102738	CA
2	133VN1004X	Pediatric Nutrition Registered Dietitian
3	133VN1005X	Renal Nutrition Registered Dietitian
4	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian
5	133VN1301X	Oncology Nutrition Registered Dietitian
6	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1891326534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRA PEREZ ARELLANO RDN

Provider Business Mailing Address
First Line	:	1985 YOSEMITE AVE STE 230
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-5200
Country	:	US
Telephone Number	:	805-870-5588
Fax Number	:	805-512-8522

Provider Business Practice Location Address
First Line	:	1985 YOSEMITE AVE STE 230
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93063-5200
Country	:	US
Telephone Number	:	805-870-5588
Fax Number	:	805-512-8522

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

Provider Enumeration Date	:	01/31/2020
Last Update Date	:	11/16/2020

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