Provider Demographics
NPI:1861389280
Name:KARAM, JOANNA
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:KARAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10977 BREEZY MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-3930
Mailing Address - Country:US
Mailing Address - Phone:951-643-9256
Mailing Address - Fax:951-643-9256
Practice Address - Street 1:1400 S FIGUEROA ST APT 208
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-4746
Practice Address - Country:US
Practice Address - Phone:951-643-9256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86099548133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered