Provider Demographics
NPI:1073669206
Name:FISCH-LEMP, JENNIFER MARIE (RD, MPH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:FISCH-LEMP
Suffix:
Gender:F
Credentials:RD, MPH
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22290 PRINCETON PL
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-5362
Mailing Address - Country:US
Mailing Address - Phone:510-537-9902
Mailing Address - Fax:510-537-9902
Practice Address - Street 1:20130 LAKE CHABOT RD STE 202
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5340
Practice Address - Country:US
Practice Address - Phone:510-219-9902
Practice Address - Fax:510-537-9902
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA35631ZZMedicare UPIN