Healthcare Provider Details

I. General information

NPI: 1255700712
Provider Name (Legal Business Name): SHAHRZAD FOROODI MS, RD, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2015
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23845 MCBEAN PKWY
VALENCIA CA
91355-2001
US

IV. Provider business mailing address

23845 MCBEAN PKWY
VALENCIA CA
91355-2001
US

V. Phone/Fax

Practice location:
  • Phone: 818-987-5003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1038804
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: