Healthcare Provider Details

I. General information

NPI: 1619967544
Provider Name (Legal Business Name): DIANA NOLAND RD MPH CCN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2005
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1834 W BURBANK BLVD
BURBANK CA
91506-1348
US

IV. Provider business mailing address

1834 W BURBANK BLVD
BURBANK CA
91506-1348
US

V. Phone/Fax

Practice location:
  • Phone: 818-840-8098
  • Fax: 818-840-7042
Mailing address:
  • Phone: 818-840-8098
  • Fax: 818-840-7042

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: