Healthcare Provider Details

I. General information

NPI: 1750593380
Provider Name (Legal Business Name): JENIFER M. GAFFANEY MS, RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2219 BATH ST
SANTA BARBARA CA
93105-4321
US

IV. Provider business mailing address

70 LOMA MEDIA RD
SANTA BARBARA CA
93103-2150
US

V. Phone/Fax

Practice location:
  • Phone: 805-682-7638
  • Fax:
Mailing address:
  • Phone: 805-884-1071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number920409
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: