Provider Demographics
NPI:1487012712
Name:PERFUMO, PAULETTE JOAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:JOAN
Last Name:PERFUMO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:PAULETTE
Other - Middle Name:JOAN
Other - Last Name:PERFUMO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:413 HEARTHSTONE CT
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-8716
Mailing Address - Country:US
Mailing Address - Phone:707-580-1589
Mailing Address - Fax:
Practice Address - Street 1:413 HEARTHSTONE CT
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-8716
Practice Address - Country:US
Practice Address - Phone:707-580-1589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist