Provider Demographics
NPI:1568737914
Name:WEINTRAUB GOLDMAN, NAAMA (RD)
Entity type:Individual
Prefix:
First Name:NAAMA
Middle Name:
Last Name:WEINTRAUB GOLDMAN
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 1:2605 LOMA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1548
Mailing Address - Country:US
Mailing Address - Phone:818-837-5559
Mailing Address - Fax:805-648-6706
Practice Address - Street 1:2605 LOMA VISTA RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1548
Practice Address - Country:US
Practice Address - Phone:805-826-1381
Practice Address - Fax:805-648-6706
Is Sole Proprietor?:No
Enumeration Date:2012-03-19
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA712635133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA712635OtherLICENSE
CACB219373Medicare PIN