Provider Demographics
NPI:1457748360
Name:VARELA, LORENA (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:VARELA
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5255 POMONA BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-1753
Mailing Address - Country:US
Mailing Address - Phone:323-832-7683
Mailing Address - Fax:323-832-7599
Practice Address - Street 1:5255 POMONA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1753
Practice Address - Country:US
Practice Address - Phone:323-832-7683
Practice Address - Fax:323-832-7599
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86016935133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered