Provider Demographics
NPI:1083071377
Name:VERMILION, JAYME DANIELLE (RD, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:JAYME
Middle Name:DANIELLE
Last Name:VERMILION
Suffix:
Gender:F
Credentials:RD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17030 MELODY LN
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95033-8406
Mailing Address - Country:US
Mailing Address - Phone:209-765-1460
Mailing Address - Fax:
Practice Address - Street 1:17030 MELODY LN
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95033-8406
Practice Address - Country:US
Practice Address - Phone:209-765-1460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered