Provider Demographics
NPI:1366509036
Name:GEMMILL, JEAN LOUISE (RD)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:LOUISE
Last Name:GEMMILL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:L
Other - Last Name:GEMMILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD
Mailing Address - Street 1:10080 N WOLFE RD
Mailing Address - Street 2:SUITE SW3-160
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-2515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10080 N WOLFE RD
Practice Address - Street 2:SUITE SW3-160
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2515
Practice Address - Country:US
Practice Address - Phone:408-342-6699
Practice Address - Fax:408-342-6622
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered