Healthcare Provider Details

I. General information

NPI: 1902363633
Provider Name (Legal Business Name): NUBIA ARMENTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4340 11TH AVE
LOS ANGELES CA
90008-5205
US

IV. Provider business mailing address

16899 JAMBOREE RD APT 131
IRVINE CA
92606-3171
US

V. Phone/Fax

Practice location:
  • Phone: 323-290-5955
  • Fax:
Mailing address:
  • Phone: 213-820-7859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: