Provider Demographics
NPI:1447203617
Name:GOARD, JOANNE C (MA RDN)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:C
Last Name:GOARD
Suffix:
Gender:F
Credentials:MA RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 BRENDAN WAY
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-6055
Mailing Address - Country:US
Mailing Address - Phone:916-541-8686
Mailing Address - Fax:
Practice Address - Street 1:1518 BRENDAN WAY
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-6055
Practice Address - Country:US
Practice Address - Phone:916-541-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA723746133V00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered