Provider Demographics
NPI:1417164971
Name:RICHARDSON-JONES, JOANNA (RD)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:RICHARDSON-JONES
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 1:6 HENNA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3965
Mailing Address - Country:US
Mailing Address - Phone:949-413-7369
Mailing Address - Fax:
Practice Address - Street 1:6 HENNA
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3965
Practice Address - Country:US
Practice Address - Phone:949-413-7369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2015-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ92371ZMedicare ID - Type Unspecified
CAQ57676Medicare UPIN