Provider Demographics
NPI:1871988162
Name:SALTZBERG, ELIZABETH (RD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SALTZBERG
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 1:2772 JOHNSON DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-8582
Mailing Address - Country:US
Mailing Address - Phone:805-644-4074
Mailing Address - Fax:805-644-4399
Practice Address - Street 1:2772 JOHNSON DR
Practice Address - Street 2:200
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-8582
Practice Address - Country:US
Practice Address - Phone:805-644-4074
Practice Address - Fax:805-644-4399
Is Sole Proprietor?:No
Enumeration Date:2015-04-02
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA881077133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered