Provider Demographics
NPI:1548870140
Name:AGUILA-VIVAR, CARIDAD (RDN)
Entity type:Individual
Prefix:
First Name:CARIDAD
Middle Name:
Last Name:AGUILA-VIVAR
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21105 OAKRIVER LN
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-4686
Mailing Address - Country:US
Mailing Address - Phone:323-603-6950
Mailing Address - Fax:
Practice Address - Street 1:21105 OAKRIVER LN
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-4686
Practice Address - Country:US
Practice Address - Phone:323-603-6950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA925432133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist