Healthcare Provider Details

I. General information

NPI: 1851138432
Provider Name (Legal Business Name): JAMIE KESSLER MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 LANKERSHIM BLVD STE 200
NORTH HOLLYWOOD CA
91602-2705
US

IV. Provider business mailing address

5767 W CENTURY BLVD STE 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 818-843-9038
  • Fax:
Mailing address:
  • Phone: 310-301-8707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86104794
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: