Healthcare Provider Details

I. General information

NPI: 1548560576
Provider Name (Legal Business Name): JANNETTE GARCIA NUTRITIONIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2010
Last Update Date: 10/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12586 AVE. 408
OROSI CA
93647-9454
US

IV. Provider business mailing address

314 NORTH MAIN STREET
PORTERVILLE CA
93257-3730
US

V. Phone/Fax

Practice location:
  • Phone: 559-528-2804
  • Fax: 559-528-7623
Mailing address:
  • Phone: 559-791-7000
  • Fax: 559-781-8193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: