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General NPI Number Information
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NPI Number | 1801371489
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Entity Type | Individual
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Provider Name | JUANA CHODAKAUSKAS REGISTERED DIETITIAN
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Gender | Female
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Dates
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Enumeration Date | 09/28/2018
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 200 N LEWIS ST
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City | ORANGE
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State | CA
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Zip | 92868-1538
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Country | US
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Telephone | 714-748-2714
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Fax |
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Provider Business Mailing Address
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Address Line | 128 S COLLEGE ST
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City | LA HABRA
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State | CA
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Zip | 90631-5503
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Country | US
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Telephone | 562-458-7540
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1102447
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License Number State | CA
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