Provider Demographics
NPI:1396341731
Name:NUTRITION 4 ALL, LLC
Entity type:Organization
Organization Name:NUTRITION 4 ALL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARIDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILA-VIVAR
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:323-603-6950
Mailing Address - Street 1:21105 OAKRIVER LN
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321-4686
Mailing Address - Country:US
Mailing Address - Phone:661-495-8883
Mailing Address - Fax:214-271-9831
Practice Address - Street 1:21105 OAKRIVER LN
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-4686
Practice Address - Country:US
Practice Address - Phone:661-495-8883
Practice Address - Fax:214-271-9831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB403626Medicaid