Provider Demographics
NPI:1588417026
Name:AMINI, NIAZ SARA (RD)
Entity type:Individual
Prefix:MS
First Name:NIAZ
Middle Name:SARA
Last Name:AMINI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:NIAZ
Other - Middle Name:SARA
Other - Last Name:SHAYESTEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:18375 VENTURA BLVD STE 127
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4218
Mailing Address - Country:US
Mailing Address - Phone:323-709-3703
Mailing Address - Fax:
Practice Address - Street 1:18375 VENTURA BLVD STE 127
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4218
Practice Address - Country:US
Practice Address - Phone:323-709-3703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered