Provider Demographics
NPI:1396035903
Name:GILLESPIE, ALISHA E (RD)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:E
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 CALIFORNIA ST
Mailing Address - Street 2:SUITE 280
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4586
Mailing Address - Country:US
Mailing Address - Phone:415-331-8390
Mailing Address - Fax:
Practice Address - Street 1:1700 CALIFORNIA ST
Practice Address - Street 2:SUITE 280
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4586
Practice Address - Country:US
Practice Address - Phone:415-331-8390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1044836133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered