Provider Demographics
NPI:1033965074
Name:COHEN, KIMBERLY (RD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:COHEN
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 1:1619 N MARTEL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-3508
Mailing Address - Country:US
Mailing Address - Phone:713-724-1689
Mailing Address - Fax:
Practice Address - Street 1:1619 1/4 N MARTEL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-3508
Practice Address - Country:US
Practice Address - Phone:323-319-5606
Practice Address - Fax:323-319-5606
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered