Healthcare Provider Details

I. General information

NPI: 1326289026
Provider Name (Legal Business Name): OKEUM S JONES RD, CDE, PHD.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S VIRGIL AVE
LOS ANGELES CA
90020-1404
US

IV. Provider business mailing address

633 E FAIRMOUNT RD
BURBANK CA
91501-1709
US

V. Phone/Fax

Practice location:
  • Phone: 213-388-0908
  • Fax:
Mailing address:
  • Phone: 818-843-7591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number85007849
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number85007849
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: