Provider Demographics
NPI:1114337383
Name:JONES, JESSICA (RD, RDN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:RD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3823 HARRISON ST 202
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-6409
Mailing Address - Country:US
Mailing Address - Phone:415-572-1444
Mailing Address - Fax:
Practice Address - Street 1:3823 HARRISON ST 202
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-6409
Practice Address - Country:US
Practice Address - Phone:415-572-1444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1067927133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered