Provider Demographics
NPI:1518459494
Name:MCBRIDE, JANET LYNN (RD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:LYNN
Last Name:MCBRIDE
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:PO BOX 460336
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94146-0336
Mailing Address - Country:US
Mailing Address - Phone:415-341-2958
Mailing Address - Fax:
Practice Address - Street 1:4444 GEARY BLVD STE 309
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-3068
Practice Address - Country:US
Practice Address - Phone:415-341-2958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA716202133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No133N00000XDietary & Nutritional Service ProvidersNutritionist