Provider Demographics
NPI:1124506381
Name:LARRAGA, ALLISON KAYLA-BARBERA (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:KAYLA-BARBERA
Last Name:LARRAGA
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:BARBERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,RDN,LDN
Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 MEDICAL PLAZA SUITE 214
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095
Practice Address - Country:US
Practice Address - Phone:310-794-7788
Practice Address - Fax:310-794-3344
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86093028133VN1006X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic