Basic Information
Provider Information
NPI: 1265943120
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KALAMI
FirstName: VENUS
MiddleName: SETAREH
NamePrefix:  
NameSuffix:  
Credential: RDN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: KALAMI
OtherFirstName: SETAREH
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: RDN
OtherLastNameType: 5
Mailing Information
Address1: 725 WELCH RD
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943041601
CountryCode: US
TelephoneNumber: 6504978000
FaxNumber:  
Practice Location
Address1: 725 WELCH RD
Address2:  
City: PALO ALTO
State: CA
PostalCode: 943041601
CountryCode: US
TelephoneNumber: 6504978000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/18/2017
LastUpdateDate: 03/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
133N00000X86076000 N Dietary & Nutritional Service ProvidersNutritionist 
133NN1002X86076000 N Dietary & Nutritional Service ProvidersNutritionistNutrition, Education
133VN1006X86076000 N Dietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic
133V00000X86076000 Y Dietary & Nutritional Service ProvidersDietitian, Registered 

No ID Information.


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