Provider Demographics
NPI:1275345779
Name:SIU, SIUWAI ELAINE (MS, RD, CNSC, CSO)
Entity type:Individual
Prefix:
First Name:SIUWAI
Middle Name:ELAINE
Last Name:SIU
Suffix:
Gender:
Credentials:MS, RD, CNSC, CSO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 E. HUNGTINGTON DR.,
Mailing Address - Street 2:STE 107 #1209
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-8501
Mailing Address - Country:US
Mailing Address - Phone:626-227-3848
Mailing Address - Fax:
Practice Address - Street 1:411 E. HUNGTINGTON DR.,
Practice Address - Street 2:STE 107 #1209
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-8501
Practice Address - Country:US
Practice Address - Phone:626-227-3848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-22
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133VN1301X
CA968867133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1301XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Oncology