Healthcare Provider Details

I. General information

NPI: 1447317672
Provider Name (Legal Business Name): VICTORIA ANN ANDERSEN MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 LAKE AVE N
WORCESTER MA
01655-0002
US

IV. Provider business mailing address

7 LEON STREET #1
WORCESTER MA
01604-4765
US

V. Phone/Fax

Practice location:
  • Phone: 508-856-1993
  • Fax:
Mailing address:
  • Phone: 508-856-1993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2034
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number2034
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: