Healthcare Provider Details

I. General information

NPI: 1013551126
Provider Name (Legal Business Name): JANINE GREENO LOESCHER RD, CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 01/15/2021
Certification Date: 01/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 BOB HOPE DR
RANCHO MIRAGE CA
92270-3221
US

IV. Provider business mailing address

PO BOX 1389
NUEVO CA
92567-1389
US

V. Phone/Fax

Practice location:
  • Phone: 760-773-1403
  • Fax:
Mailing address:
  • Phone: 619-261-0871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number718025
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: