Provider Demographics
NPI:1568703502
Name:LYON, TAMI JO (RD)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:JO
Last Name:LYON
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 1:3608 SACRAMENTO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1736
Mailing Address - Country:US
Mailing Address - Phone:415-345-1354
Mailing Address - Fax:888-945-6887
Practice Address - Street 1:3608 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1736
Practice Address - Country:US
Practice Address - Phone:415-345-1354
Practice Address - Fax:888-945-6887
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered