Healthcare Provider Details

I. General information

NPI: 1831238799
Provider Name (Legal Business Name): CHIENFANG RIVA HUANG MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RIVA HUANG

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

528 KENDALL AVE APT 1
PALO ALTO CA
94306-2760
US

IV. Provider business mailing address

528 KENDALL AVE APT 1
PALO ALTO CA
94306-2760
US

V. Phone/Fax

Practice location:
  • Phone: 425-829-3621
  • Fax:
Mailing address:
  • Phone: 425-829-3621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number952343
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: