Healthcare Provider Details

I. General information

NPI: 1689596041
Provider Name (Legal Business Name): YULIA RIRDAN RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 E 6TH ST
MESA AZ
85203-7104
US

IV. Provider business mailing address

4081 E STABLE CT
GILBERT AZ
85297-8393
US

V. Phone/Fax

Practice location:
  • Phone: 480-427-3020
  • Fax:
Mailing address:
  • Phone: 480-294-1226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: