Provider Demographics
NPI:1174693501
Name:JIERIAN, SHAHE N (PHD)
Entity type:Individual
Prefix:DR
First Name:SHAHE
Middle Name:N
Last Name:JIERIAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1668 E WASHINGTON BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107
Mailing Address - Country:US
Mailing Address - Phone:818-469-4101
Mailing Address - Fax:
Practice Address - Street 1:1668 E WASHINGTON BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-2757
Practice Address - Country:US
Practice Address - Phone:818-469-4101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered132700000XDietary & Nutritional Service ProvidersDietary Manager
Not Answered170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Not Answered133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education