Provider Demographics
NPI:1285264853
Name:HOBLICK, AYAKO (RD)
Entity type:Individual
Prefix:
First Name:AYAKO
Middle Name:
Last Name:HOBLICK
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 1:27595 EDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92883-6604
Mailing Address - Country:US
Mailing Address - Phone:951-893-8983
Mailing Address - Fax:
Practice Address - Street 1:27595 EDGEMONT DR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92883-6604
Practice Address - Country:US
Practice Address - Phone:951-893-8983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered