Provider Demographics
NPI:1659103372
Name:ALAGATA, HANNAH M (RDN)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:M
Last Name:ALAGATA
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 1:20701 BEACH BLVD SPC 62
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-4976
Mailing Address - Country:US
Mailing Address - Phone:714-642-3822
Mailing Address - Fax:
Practice Address - Street 1:20701 BEACH BLVD SPC 62
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-4976
Practice Address - Country:US
Practice Address - Phone:714-642-3822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86325827133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered