Provider Demographics
NPI:1083898688
Name:SALEM, CHRISTIANNE HAMILTON (RD)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIANNE
Middle Name:HAMILTON
Last Name:SALEM
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:CHRISTIANNE
Other - Middle Name:MARIE
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:23371 MULHOLLAND DR # 216
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2734
Mailing Address - Country:US
Mailing Address - Phone:818-399-3903
Mailing Address - Fax:
Practice Address - Street 1:23371 MULHOLLAND DR # 216
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2734
Practice Address - Country:US
Practice Address - Phone:818-399-3903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA960887133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered