Healthcare Provider Details

I. General information

NPI: 1952860595
Provider Name (Legal Business Name): ANDREW ROGER OSSA RDN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6219 OXSEE AVE
WHITTIER CA
90606-1537
US

IV. Provider business mailing address

6219 OXSEE AVE
WHITTIER CA
90606-1537
US

V. Phone/Fax

Practice location:
  • Phone: 562-713-4615
  • Fax:
Mailing address:
  • Phone: 562-713-4615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86098381
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: