Provider Demographics
NPI:1417780800
Name:AL-ANI, SUMER (RD, LDN)
Entity type:Individual
Prefix:
First Name:SUMER
Middle Name:
Last Name:AL-ANI
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 SADDLE RACK ST APT 444
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-5121
Mailing Address - Country:US
Mailing Address - Phone:972-352-9972
Mailing Address - Fax:
Practice Address - Street 1:1390 SADDLE RACK ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-5112
Practice Address - Country:US
Practice Address - Phone:972-352-9972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADN007704133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered