Provider Demographics
NPI:1104075910
Name:ROSENTHAL, ALISON KATE (MS, RD)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:KATE
Last Name:ROSENTHAL
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BICKNELL AVE
Mailing Address - Street 2:APT. 211
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-2394
Mailing Address - Country:US
Mailing Address - Phone:310-367-1500
Mailing Address - Fax:
Practice Address - Street 1:201 BICKNELL AVE
Practice Address - Street 2:APT. 211
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-2394
Practice Address - Country:US
Practice Address - Phone:310-367-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1002281133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered