Provider Demographics
NPI:1154766020
Name:ROZENFELD, SHERA
Entity type:Individual
Prefix:MRS
First Name:SHERA
Middle Name:
Last Name:ROZENFELD
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SHERA
Other - Middle Name:
Other - Last Name:ROZENFELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LD
Mailing Address - Street 1:23123 VENTURA BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1181
Mailing Address - Country:US
Mailing Address - Phone:818-222-2286
Mailing Address - Fax:
Practice Address - Street 1:23123 VENTURA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1181
Practice Address - Country:US
Practice Address - Phone:818-222-2286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004016-1133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist