Provider Demographics
NPI:1194479279
Name:BRANDO, ELONA (RD)
Entity type:Individual
Prefix:
First Name:ELONA
Middle Name:
Last Name:BRANDO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12065 EDDLESTON DR
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1307
Mailing Address - Country:US
Mailing Address - Phone:818-256-7919
Mailing Address - Fax:
Practice Address - Street 1:12065 EDDLESTON DR
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-1307
Practice Address - Country:US
Practice Address - Phone:818-256-7919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes136A00000XDietary & Nutritional Service ProvidersDietetic Technician, Registered