MEDICARE: NUBIA ARMENTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133NN1002X	Nutrition Education Nutritionist		CA

General Provider Information

NPI Number	:	1902363633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NUBIA ARMENTA

Provider Business Mailing Address
First Line	:	16899 JAMBOREE RD APT 131
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92606-3171
Country	:	US
Telephone Number	:	213-820-7859
Fax Number	:

Provider Business Practice Location Address
First Line	:	4340 11TH AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90008-5205
Country	:	US
Telephone Number	:	323-290-5955
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2019
Last Update Date	:	02/28/2019

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