Provider Demographics
NPI:1588286751
Name:HADANI, SHIR (RD)
Entity type:Individual
Prefix:
First Name:SHIR
Middle Name:
Last Name:HADANI
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 1:24201 TORENA CIR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-4446
Mailing Address - Country:US
Mailing Address - Phone:408-707-6143
Mailing Address - Fax:
Practice Address - Street 1:24201 TORENA CIR
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-4446
Practice Address - Country:US
Practice Address - Phone:408-707-6143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86099155133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered