Provider Demographics
NPI:1609845916
Name:LEHMAN, JAIME N (RD, CDE)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:N
Last Name:LEHMAN
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13640 N PLAZA DEL RIO BLVD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4846
Mailing Address - Country:US
Mailing Address - Phone:623-876-3800
Mailing Address - Fax:623-933-1180
Practice Address - Street 1:13640 N PLAZA DEL RIO BLVD
Practice Address - Street 2:SUITE 340
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4846
Practice Address - Country:US
Practice Address - Phone:623-876-6960
Practice Address - Fax:623-933-1180
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ926214133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ832990Medicaid
AZZ111625Medicare PIN